37th Week Of Gestation Research Articles

Prevalence of Gestational Diabetes Mellitus in Obstetric patients, using Macrosomia and Increased Amniotic Fluid on Ultrasound as Diagnostic Markers

Aim: To determine the prevalence of gestational diabetes in obstetric patients with the help of ultrasonography and diagnostic biomarkers such as increased amniotic fluid and macrosomia. Methods: In 110 women who failed the glucose tolerance test, longitudinal ultrasound measurements of foetal growth were taken during the first, second and third trimesters with the informed consent of every pregnant women. 524 ultrasound examinations were performed in total, and uncomplicated pregnancies were included as controls for the comparison of our results. Head circumference (HC), abdominal circumference (AC), femur length (FL) and head circumference to abdominal circumference ratio (HC/AC) was evaluated at 17th and 37th weeks of gestation while amniotic fluid was measured and recorded at 13th, 27th and 37th weeks of gestation respectively. Results: The mean HbA1c (%) of the pregnant women in 1st semester recorded was 5.2±0.27SD which increased to 5.31±0.24SD in 2nd trimester and later changed to 5.54±0.17SD in 3rd semester. The measured amniotic fluid in ultrasound was 23.23cm±3.18 SD at 13th weeks of gestation, 15.97cm±2.62SD at 27th weeks and 11.95cm±1.99SD at 37th week. The mean abdominal circumference at 37th week was 347.01mm±7.28SD, mean head circumference was 1477.50mm±2.88SD, AC/HC ratio at 37th week estimated 0.89±0.08SD and femur length was 73.44mm±2.28SD respectively. Conclusion: The finding suggests that increased amniotic fluid and macrosomia are important biomarkers of gestational diabetes and can be assessed through ultrasonography. Keywords: Gestational diabetes, ultrasonograpy, increased antibiotic, macrosomia

Urine Biochemistry of a Human Fetus with Urinary Tract Obstruction – A Case Report

Introduction Fetal lower urinary tract obstruction (LUTO) can be mild or severe with oligohydramnios, renal dysplasia and pulmonary hypoplasia. Fetal urine biochemical markers correlate with fetal prognosis and, if favorable, surgical intervention is feasible. Methods We report a patient in her 18th gestational week whose fetus was diagnosed with LUTO and underwent fetal urine sampling for calcium, sodium, chloride, beta2-microglobulin and total protein of the routine LUTO panel, with the addition of creatinine, glucose, phosphate, urea, ammonia, albumin, and NGAL. Results Although the routine fetal urine biochemistry seemed to be favorably trending favorably, sodium, beta2-microglobulin, glucose, and urea did not decrease to the reference ranges, and ammonia and creatinine were lower than the reference ranges. Ultrasound demonstrated no improvement of the obstruction. Conclusions This case highlights the need to acquire further experience with biochemical fetal urine markers in order to better manage LUTO.

Maternal Mood and Perception of Infant Temperament at Three Months Predict Depressive Symptoms Scores in Mothers of Preterm Infants at Six Months.

Postpartum depression is more prevalent in mothers and fathers of preterm infants compared to parents of full-term infants and may have long-term detrimental consequences for parental mental health and child development. The temperamental profile of an infant has been postulated as one of the important factors associated with parental depressiveness in the first months postpartum. This study aimed to examine the longitudinal relationship between depressive symptoms and perceived infant temperament at 3 months corrected age, and depressive symptoms at 6 months corrected age among mothers and fathers of infants born preterm. We assessed 59 families with infants born before the 34th gestational week using the Edinburgh Postnatal Depression Scale (EDPS) and the Infant Behavior Questionnaire-Revised. We found that mothers’ scores on EPDS and infants’ Orienting/regulation at 3 months corrected age predicted mothers’ EPDS scores at 6 months corrected age. In particular, higher depressive scores were related to higher depressive symptoms at 6 months corrected age, whereas higher infant Orienting/regulation was related to lower depressive symptoms at 6 months corrected age. Due to the low internal consistency of EPDS at 6 months for fathers, we were unable to conduct similar analyses for fathers. Our results point to the importance of considering both early indices of maternal mood as well as mother-reported measures of preterm infant temperament in the attempts to predict levels of maternal depressiveness in later months of an infant’s life. Further studies are urgently needed in order to better understand the associations between depressiveness and infant temperament in fathers, and with more consideration for the severity of the effects of infant prematurity.

The effects of early or late multifetal reduction procedure on perinatal outcomes in multiple pregnancies reduced to twins or singletons: A single tertiary center experience

ObjectiveThe aim of the study was to compare the effect of early or late fetal reduction (FR) procedures on perinatal outcomes in multiple pregnancies reduced to twins or singletons. Study DesignThis retrospective cohort study consisted of data from a single tertiary center between January 2013 and December 2020 and included 103 women with multiple pregnancies between 8 and 14 gestational weeks and who underwent FR by transabdominal approach. Late FR was defined as 11–13 6/7 gestational weeks (Group L) and early FR was defined as 8–10 6/7 gestational weeks (Group E) in the study. All pregnancies with FR were named Group S (Single) if reduced to singletons and Group T (Twin) if reduced to twin pregnancies. ResultsThirty four percent (n = 35) were reduced to single pregnancy, the remaining 66% of these cases (n = 68) were reduced to twin pregnancy. The overall survival rate was 90%.When the cases were examined in terms of pregnancy complications, it was observed that the PPROM rate and preterm labor rate in the Group T were statistically significantly higher than the Group S (p = 0.015 and p < 0.001, respectively). When comparing the overall survival results between Group S and Group T, it was found that the overall survival of Group S was statistically significantly better (p < 0.001). When Group E and Group L were compared in terms of their pregnancy course and neonatal outcomes, no statistically significant difference was found between them. No statistically significant difference was found between the complication rates in the first week after the procedure (p < 0.05). Neonatal intensive care need was found at a rate of 31% in those with Group E, while this rate was found as 39% in Group L, and this difference was also not statistically significant (p = 0.480). When the preterm labor rate was compared between these two groups, there was no statistically significant difference in all three subgroups (<32nd, <34th, and <37th gestational weeks). ConclusionWhen FR to singleton is required for fetal or maternal reasons, it should be discussed with the parents that the risk of fetal loss is similar to FR to twins, but the effect on perinatal survival is more favorable than expected.

The impact of fetal sex on risk factors for gestational diabetes and related adverse pregnancy outcomes.

To investigate whether fetal sex affects the impact of classical GDM risk factors on the diagnosis of gestational diabetes (GDM) as well as on related adverse pregnancy outcomes. This retrospective observational study concerned 206,917 singleton live births born to 170,126 women aged 15-45 over the years 2010-2018 in Tuscany, Italy. GDM was identified by administrative data-sources in 21,613 pregnancies (10.5%) by assessing, through multiple logistic models, whether fetal sex modified the risk of GDM driven by maternal risk factors, and whether it modified the risk of adverse outcomes such as prematurity (birth ≤ 37th gestational week), large for gestational age (LGA), unplanned caesarean sections, or 5-min-Apgar-index ≤ 7 in pregnancies with GDM. GDM was diagnosed in 21,613 pregnancies (10.5%). Male fetal sex predicted a higher adjusted risk of GDM: OR = 1.05(95% CI: 1.01-1.07); p < 0.0009. In pregnancies with female sex, pre-pregnancy obesity amplified the risk of GDM: OR = 1.09(95% CI: 1.01-1.19); p = 0.04. In pregnancies with GDM, carrying a female fetus increased the risk of LGA associated with pregestational obesity OR = 1.45(95% CI: 1.15-1.81); p = 0.001, and in primiparous pregnancies, it protected mothers from the risk of unplanned caesarean sections OR = 0.80(95%CI: 0.67-0.92); p = 0.001. While male fetal sex is associated with rise in the risk of GDM, giving birth to a girl amplifies the excess GDM risk driven by pregestational obesity, thus increasing the risk of LGA in pregnancies with GDM. Additionally, female fetal sex in pregnancies with GDM seems to protect from the risk of unplanned caesarean sections in primiparous pregnancies.

CONGENITAL LIMBS DEFICIENCY VERSUS PHOCOMELIA THE HARD WORKUP WITH THE SUBTLETIES AND MALFORMATIONS ACCOMPANYING THE SYNDROMES IMAGES; CASE SERIES

Background; Limb Deficiencies syndrome (LDS) is a spectrum of abnormalities that is present at birth. LDS are missing or incomplete limbs at birth. LDS can be Longitudinal (more common), or transverse deficiencies that involve specific mal developments. Splint hand foot malformation (SHFM) is one of the images of these deficiencies. LDS has been reported in conjunction with more than 75 genetic syndromes. Objective; We reported the conflicting images of these two rare malformations to claim knowledge about the presentation, having features of both, critically associated anomalies, and the workup consideration with the treatment options. Presentation; CASE 1: a 2-day-old female neonate born at full term through Cesarean delivery at 37th week of gestation, presented with persistent cloaca. The patient was noted to have deformities resembling a “lobster claw” to both her feet, and each hand had only a single-digit, the foot may not have all five toes; the right leg is shorter than the other (a leg length discrepancy) with stable hips. CASE 2: a 37-week gestation male infant was born via cesarean section to a 32-year-old mother (consanguineous marriage). A routine prenatal ultrasound study revealed images of relatively undeveloped limbs and pelvic bones with an accumulation of spinal fluid under the skull (hydrocephalus). On initial assessment, the infant was noted to have facial abnormalities, Shortened neck, the eyes pointed downward. Images of phocomelia were suggested. Conclusion; LDS and phocomelia are very diverse in their epidemiology, etiology, and anatomy and usually require a low threshold and careful intervention to improve functional and aesthetic outcomes. Physicians and caregiver should assign their workup precisely for the evaluations following initial diagnosis, prevention of primary manifestations, and prevention of secondary complications.

Prevalence of Group B Streptococcus Colonization in Pregnant Women at a University Hospital in Korea.

Group B Streptococcus (GBS) colonization in pregnant women is a risk factor for causing infection in neonates; therefore, GBS screening tests are performed on them. Culture methods and molecular diagnostics are mainly performed for GBS detection; however, culture methods differ in the detection rate for GBS depending on the procedure of culture. The authors intended to confirm the difference in GBS colonization rate in the conventional culture method, enrichment culture method, and molecular genetic test as screening tests for GBS. Duplicate vagino-rectal swabs were collected from 371 pregnant women between the 35th and 37th week of gestation; one was used for conventional culture method and the other was frozen at -80℃, followed by enrichment culture method and molecular genetic test. The prevalence of GBS colonization identified by conventional culture, enrichment culture, and molecular genetic test was 4.35% (17/391), 8.95% (35/391), and 22.25% (87/391), respectively. The detection rate by enrichment culture method was 2.06 times higher (17/391 vs. 35/391) than that by conventional culture method. It was identified that there was a significant difference in the detection rates of GBS between the two methods (p < 0.001). The detection rate identified in molecular genetic test was much higher at 22.25% (87/391). The concordance rate of the results from three detection methods for GBS was 80.05% (313/391). All pregnant women colonized with GBS were given intrapartum antibiotic prophylaxis using cefazolin and their neonates were confirmed not to be infected with GBS. Prevalence of GBS colonization in pregnant women is shown to vary depending on detection method. Particularly, it differs greatly depending on the use of enrichment media in the culture method. Therefore, it is necessary that the microbiological laboratory implements the culture method with supplementary procedures such as selective or enrichment media in order to improve the detection rate of GBS.

Comparison of umbilical coiling index in term pregnancies with and without fetal growth restriction

Objective: To investigate pregnancies with and without fetal growth restriction, giving birth after 37 weeks of gestation in terms of umbilical coiling index and neonatal outcomes. Materials and Methods: Twenty-nine patients with fetal growth restriction and 46 patients who have normal pregnancy and delivered after the 37th week of gestation were recruited in this study. The umbilical coiling index was measured by ultrasound, following the patients who were hospitalized for delivery. Results: There were statistically significant differences between the groups regarding to umbilical artery pulsatility index, gestational age at delivery and birth weight of the newborn. The need for a cesarean section because of non-reassuring fetal condition was statistically significantly higher in the fetal growth restriction group. The mean antenatal umbilical coiling index in fetal growth restriction and control patients was 0.29±0.08 and 0.27±0.08, respectively and the difference was not statistically significant. Conclusion: There was no statistically significant difference between the patients diagnosed with and without fetal growth restriction who delivered after the 37th gestational week, regarding the umbilical coiling index and perinatal outcomes, except umbilical artery pulsatility index, gestational age at birth and birth weight of the newborn.

Intrauterine Volvulus

Although volvulus is mostly seen in infancy, rare cases of intrauterine volvulus have also been reported. Fetal ultrasonographic (USG) examination of a 32-year-old woman at the 24th gestational week, showed focal dilatation of the intestines with an increased wall echogenity of the dilated segments. At the subsequent visits USG revealed progressive dilatation of the intestines. The patient presented with preterm labor at the 32nd gestational week. Cullen's sign developed on newborn's abdominal skin over time. During the operation, there was a stiff, yellowcolored, fibrinous pouch, jejunal and ileal atretic ends (25 cm of jejunum was remaining). We started total parenteral nutrition (TPN) because of short bowel syndrome. The patient died due to TPN-related sepsis at age 40 days. Timely diagnosis and treatment of intrauterine volvulus cases is very difficult because there are mostly non-specific signs, which have many differential diagnoses. This fact negatively affects mortality and morbidity for intrauterine volvulus cases.

Prenatalno otkrivena trizomija 18q - Edvardsov sindrom

Introduction: Most fetuses with trisomy 18 have an abnormal ultrasound results. Trisomy of the long arm of chromosome 18 is an important factor in the development of the phenotype of Edwards syndrome. Case report: A 28 year old woman, in 24th gestational week of her first pregnancy, was referred to our clinic for genetic counseling, after combined screening for aneuploidies in the first trimester of her pregnancy showed increased risk for trisomy 13 and 18, and fluorescent in situ hybridization (FISH) from amniotic fluid results were obtained only for chromosomes 13, 21 and sex chromosomes, showing euploid constitution, but for the chromosome 18 there were no findings. After careful analysis of the obtained results, geneticist suggested a thorough ultrasonography examination of the fetus that showed polyhydramnion, asymmetrical ventriculomegaly and agenesis of corpus callosum. Consequent cytogenetic analysis showed karyotype 46,XX,-13,+der(13),t(13;18)(p11;q11). Parents had normal karyotypes, so finding of trisomy 18q in fetus, is due to de novo translocation. After genetic counseling, on parents demand and after ethic committee approval, this pregnancy was terminated and autopsy revealed dysmorphic facial features (including triangular face, low-set ears, short palpebral fissures), clenched hands, ventriculomegaly, choroid plexus cysts, partial agenesis of corpus callosum, subaortic ventricular septum defect, bilateral, trilobate lungs and saccular stage of lung development. Conclusion: Karyotyping of fetuses with high risk for chromosomal disorders is necessary not only for the confirmation of clinical diagnosis, but also for a proper genetic counseling.

Peripartum access to care in Mozambique: Opportunities for reducing maternal mortality

Women's health is prioritised in national health policies and strategies in Mozambique. However, only 34.1% of women start antenatal consultations before the 16th gestational week and attend at least 4 visits – the reported lack of easy access to health facilities contributing to late initiation of antenatal care. Data from the Mozambique National Audit Committee of maternal, perinatal, and neonatal deaths demonstrate institutional maternal mortality ratio increased from 81 deaths per 100 000 live births in 2016 to 84 in 2019, highlighting the need for greater surveillance and a vigorous response to this increase. In Mozambique, there are opportunities for improving access to and quality of peripartum care to reduce maternal morbidity and mortality. Research is needed to uncover the major causes of maternal mortality and morbidity, particularly the role of cardiovascular disease.

Exosome-Enriched Plasma Analysis as a Tool for the Early Detection of Hypertensive Gestations.

Hypertensive disorders of pregnancy are closely associated with prematurity, stillbirth, and maternal morbidity and mortality. The onset of hypertensive disorders of pregnancy (HDP) is generally noticed after the 20th week of gestation, limiting earlier intervention. The placenta is directly responsible for modulating local and systemic physiology by communicating using mechanisms such as the release of extracellular vesicles, especially exosomes. In this study, we postulated that an analysis of exosome-enriched maternal plasma could provide a more focused and applicable approach for diagnosing HDP earlier in pregnancy. Therefore, the peripheral blood plasma of 24 pregnant women (11 controls, 13 HDP) was collected between 20th and 24th gestational weeks and centrifuged for exosome enrichment. Exosome-enriched plasma samples were analyzed by Raman spectroscopy and by proton nuclear magnetic resonance metabolomics (1H NMR). Principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA) were used to analyze the Raman data, from the spectral region of 600–1,800 cm–1, to determine its potential to discriminate between groups. Using principal component analysis, we were able to differentiate the two groups, with 89% of all variances found in the first three principal components. In patients with HDP, most significant differences in Raman bands intensity were found for sphingomyelin, acetyl CoA, methionine, DNA, RNA, phenylalanine, tryptophan, carotenoids, tyrosine, arginine, leucine, amide I and III, and phospholipids. The 1H NMR analysis showed reduced levels of D-glucose, L-proline, L-tyrosine, glycine, and anserine in HDP, while levels of 2-hydroxyvalerate, polyunsaturated fatty acids, and very-low-density lipoprotein (VLDL) were increased. 1H NMR results were able to assign an unknown sample to either the control or HDP groups at a precision of 88.3% using orthogonal partial least squares discriminant analysis and 87% using logistic regression analysis. Our results suggested that an analysis of exosome-enriched plasma could provide an initial assessment of placental function at the maternal-fetal interface and aid HDP diagnosis, prognosis, and treatment, as well as to detect novel, early biomarkers for HDP.

Evaluation of Repeated Web-Based Screening for Predicting Postpartum Depression: Prospective Cohort Study.

BackgroundPostpartum depression (PPD) is a severe mental disorder that often results in poor maternal-infant attachment and negatively impacts infant development. Universal screening has recently been recommended to identify women at risk, but the optimal screening time during pregnancy has not been defined so far. Thus, web-based technologies with widespread use among women of childbearing age create new opportunities to detect pregnancies with a high risk for adverse mental health outcomes at an early stage.ObjectiveThe aim of this study was to stratify the risk for PPD and to determine the optimal screening time during pregnancy by using a web-based screening tool collecting electronic patient-reported outcomes (ePROs) as the basis for a screening algorithm.MethodsIn total, 214 women were repeatedly tested for depressive symptoms 5 times during and 3 times after pregnancy by using the Edinburgh Postnatal Depression Scale (EPDS), accessible on a web-based pregnancy platform, developed by the authors of this study. For each prenatal assessment, the area under the curve (AUC), sensitivity, specificity, and predictive values for PPD were calculated. Multivariate logistic regression analyses were applied to identify further potential predictors, such as age, education, parity, relationship quality, and anxiety, to increase predictive accuracy.ResultsDigitally collected data from 214 pregnant women were analyzed. The predictive accuracy of depressive symptoms 3 and 6 months postpartum was reasonable to good regarding the screening in the second (AUC=0.85) and third (AUC=0.75) trimester. The multivariate logistic regression analyses resulted in an excellent AUC of 0.93 at 3 months and a good AUC of 0.87 at 6 months postpartum.ConclusionsThe best predictive accuracy for PPD has been shown for screening between the 24th and the 28th gestational week (GW) and seems to be beneficial for identifying women at risk. In combination with the aforementioned predictive factors, the discriminatory power improved, particularly at 3 months postpartum. Screening for depression during pregnancy, combined with the women’s personal risk profile, can be used as a starting point for developing a digital screening algorithm. Thereby, web-based assessment tools constitute feasible, efficient, and cost-effective approaches. Thus, they seem to be beneficial in detecting high-risk pregnancies in order to improve maternal and infant birth outcomes in the long term.

Premature rupture of membrane and perinatal outcome

Objective: To find out the complications of a pregnant woman with premature rupture of membrane (PROM) and assess the outcome of it. Materials and Methods: This prospective study was carried out at the Department of Obstetrics &amp; gynecology of Coronel Malek Medical College Hospital, Manikgonj, Bangladesh from January 2020 to December 2020. All pregnant women admitted with PROM during this period were taken as the study population. After taking proper history they were categorized as a term or preterm PROM on the basis of duration of gestation estimated from 1st day of last menstrual period (LMP), previous antenatal records, clinical examination &amp; also previous ultrasonography (USG) reports. Out of sociodemographic characteristics, age distribution and gravidity were noted. The diagnosis was done on the basis of examination and investigations. All the women with PROM were then followed up, management was given according to protocol and a cesarean section was performed according to indication. Birth weight and Apgar score of newborns were noted after delivery. Results: There were 297 cases of PROM recorded among 4461 admitted obstetrical patients over one year period. The hospital incidence of PROM was found to be 6.6%. Among them, 57.6% of patients were admitted at term and 42.4% of patients came before 37 completed weeks of gestation. Most of the pregnant women were between 20-24 years of age (43.7%), 43.2% were primigravida (56.6%) were multigravida. About 48.5% of women presented with different complications associated with PROM. Among which 15.7% of patients had oligohydramnios, 8.5% of patients presented with chorioamnionitis suggested by culture report of the high vaginal swab. Urine for culture and sensitivity was also done. About five (5.2%) developed premature labor before the 37th week of gestation. About 10% of women developed obstetric complications (failed trials) associated with medical diseases. Seventy-seven patients were delivered by cesarean section, 16.2% vaginally, 4.04% patients responded to conservative management and 2.5% patients were referred to a tertiary center for extreme prematurity with associated complicating factors. Most of the babies (38.4%) were born with birth weight between 2.1- 2.5kg and 10.3% of babies were less than 1.5kg. Conclusion: Term PROM was more in comparison to PPROM and most of them were multigravida. The cesarean section rate was high. Most common complication of was subclinical urogenital infection (53%) next oligohydramnios (25%) &amp; (13.5%) women presented with chorioamnionitis.

Group B Streptococci Vaginal-Recto Colonization, Vertical Transmission to Newborns, Antimicrobial Susceptibility Profile and Associated Factors in Selected Health Facilities of Bahir Dar City: A Cross-Sectional Study.

BackgroundGroup B streptococci (GBS) is an important pathogen involved in stillbirths, neonatal deaths and neurological defects, and the occurrence of multi-drug resistance (MDR) is an alarming issue. This study determined the prevalence of GBS colonization in pregnant women and newborns, the proportion of vertical transmission, antimicrobial susceptibility profiles of isolates, and the factors associated with colonization and vertical transmission.MethodsA cross-sectional study was conducted from March 1, 2021 to June 30, 2021, at selected health facilities of Bahir Dar city. Vaginal-recto swabs from 292 pregnant women and pooled ear, nasal and umbilical swabs from 292 newborns were collected. GBS were identified following standard microbiological protocols. Antimicrobial susceptibility testing was performed using modified Kirby–Bauer disk diffusion method and interpreted by the accepted 2020 CLSI M100 guidelines. Logistic regression analysis was computed.ResultsOverall, 54 (18.5%) of pregnant women and 22 (7.5%) of newborns had GBS colonization. The proportion of GBS vertical transmission was 22 (40.7%). Group B Streptococcus isolates scored susceptibility to penicillin, ampicillin and vancomycin with 88.9%, 90.7%, and 96.3% for pregnant women and 86.4%, 90.9% and 95.9% for newborns, respectively. A high percentage of non-susceptibility was found for clindamycin and erythromycin with 33.3% and 25.9% for pregnant women and 31.8% and 22.7% from newborns, respectively. Besides, 19 (35.2%) GBS from pregnant women and 8 (36.4%) from newborns were MDR. Group B streptococci colonization was significantly associated with delivery before 37th week of gestation (AOR=2.77, 95% CI 1.14–6.68) and history of stillbirth (AOR=3.13, 95% CI 1.13–8.70).ConclusionPregnant women vaginal-recto GBS colonization and transmission to newborns connected with MDR are a matter of concerns. Although non-susceptible GBS isolates are obtained, penicillin and vancomycin are relatively effective. The use of clindamycin, erythromycin and ceftriaxone should be guided by antimicrobial susceptibility testing. Genetic analysis is recommended to exactly identify the epidemiology of GBS strains, vertical transmission and antimicrobial resistance at the country level.

The association between increased maternal PARK7 (DJ-1) levels and the occurrence of preterm premature rupture of membranes - A randomized prospective study

Objective:Parkinson’s disease protein 7 (PARK7/DJ-1) is an important antioxidant multiprotein against inflammation and oxidative stress. We therefore planned this study to demonstrate the association between maternal PARK7 levels and the occurrence of preterm premature rupture of membranes (PPROM).Materials and Methods:We enrolled 80 pregnant women; 50 PPROM patients and 30 healthy controls, into this cross- sectional study between the 24th and 36th gestational weeks. Furthermore, we measured serum PARK 7 levels using enzyme-Linked immunosorbent assay method.Results:Plasma PARK7 levels were higher in PPROM patients compared to those in the healthy controls (p<0.001). With a cutoff value of 2.57 pg/mL; PARK 7 had a 92% sensitivity, 86% specificity, 88% positive predictive value and 83% negative predictive value (p<0.01) for PPROM. PARK7 had positive correlation with blood leukocyte levels (p<0.001), C-reactive protein levels (p<0.001), and negatively correlated with birth weight and birth week.Conclusion:PARK 7 is overexpressed in PPROM patients. Due to its anti-inflammatory and antioxidant properties, PARK7 may be a novel marker in better understanding the pathophysiology and prediction of the prognosis PPROM. Further large-scale studies are needed.

Maternal amylase, lipase, lactate dehydrogenase, creatine kinase levels at preterm delivery, and the effect of tocolysis

Background/Aim: Preterm labor is one of the main obstetric problems and the leading cause of neonatal mortality and morbidity. Some pregnant women at risk of preterm labor receive tocolytic therapy, but the agents used can affect maternal blood parameters and enzyme levels. Physiological changes that occur during pregnancy may cause changes in enzymatic activities. Maternal amylase, lipase, lactate dehydrogenase (LDH), and creatine kinase (CK) levels should be followed throughout pregnancy to assess any increase. This study aimed to examine maternal amylase, lipase, creatine kinase, and lactate dehydrogenase levels in pregnant women who gave term and preterm birth and determine the physiological changes that may occur with gestational age and tocolysis. Methods: The records of patients over their 24th gestational week who gave birth at the Gynecology and Obstetrics Department of Okmeydani Training and Research Hospital between July-December 2018 were reviewed in this retrospective cohort study. Their clinical findings, maternal and obstetric outcomes were noted. A total of 548 pregnant women were included in the study, who were divided into three groups: Group 1- Preterm delivery without tocolysis, Group 2- Preterm delivery with tocolysis, Group 3- Term delivery Results: The maternal age, gravidity, history of abortion, fetal gender, amylase, and lipase values were similar between the groups (p>0.05 for all), while delivery types and cesarean section indications significantly differed (p=0.009, and p

Associations of COVID-19 lockdown with gestational length and preterm birth in China

BackgroundThe effects of COVID-19 lockdown measures on maternal and fetal health remain unclear. We examined the associations of COVID-19 lockdown with gestational length and preterm birth (PTB) in a Chinese population.MethodsWe obtained medical records of 595,396 singleton live infants born between 2015 and 2020 in 5 cities in Guangdong Province, South China. The exposed group (N = 101,900) included women who experienced the COVID-19 Level I lockdown (1/23–2/24/2020) during pregnancy, while the unexposed group (N = 493,496) included women who were pregnant during the same calendar months in 2015–2019. Cumulative exposure was calculated based on days exposed to different levels of emergency responses with different weighting. Generalized linear regression models were applied to estimate the associations of lockdown exposure with gestational length and risk of PTB (< 37 weeks).ResultsThe exposed group had a shorter mean gestational length than the unexposed group (38.66 vs 38.74 weeks: adjusted β = − 0.06 week [95%CI, − 0.07, − 0.05 week]). The exposed group also had a higher risk of PTB (5.7% vs 5.3%; adjusted OR = 1.08 [95%CI, 1.05, 1.11]). These associations seemed to be stronger when exposure occurred before or during the 23rd gestational week (GW) than during or after the 24th GW. Similarly, higher cumulative lockdown exposure was associated with a shorter gestational length and a higher risk of PTB.ConclusionsThe COVID-19 lockdown measures were associated with a slightly shorter gestational length and a moderately higher risk of PTB. Early and middle pregnancy periods may be a more susceptible exposure window.

Prenatal exposure to air pollution and the risk of macrosomia: Identifying windows of susceptibility

This study explores the effects of prenatal exposure to air pollution on the risk of macrosomia and its window of susceptibility.We conducted a retrospective cohort study utilizing records of birth certificates for all full-term live newborns born in Xi'an city, China from January 1, 2015, to December 31, 2018.Weekly- and trimester-specific exposures of PM2.5, PM10, NO2, and O3 during pregnancy were calculated by inverse distance weighting (IDW) based on their residences. Cox proportional hazard model and distributed lag models (DLMs) were performed to estimate the effects of air pollution exposure during pregnancy on macrosomia risk and its window of susceptibility.In total, 318,323 full-term newborns were identified, including 24,996 (7.8%) cases of macrosomia. An IQR increase in PM2.5 exposure (45.46 μg/m3) from the 33rd until the 37th weeks of gestation was positively associated with an elevated risk of macrosomia, with the strongest effect in the 37th weeks (HR = 1.007, 95%CI: 1.002–1.013). The window of susceptibility for NO2 exposure on macrosomia risk was in the 29th–35th gestational weeks, with the strongest effect in the 34th weeks (IQR = 21.96 μg/m3, HR = 1.006, 95%CI:1.000–1.013). For prenatal exposure to O3, 5th–24th weeks of gestation was identified as susceptible windows for elevated risk of macrosomia, with the strongest associations observed in the 15th weeks (IQR = 80.53 μg/m3, HR = 1.022, 95%CI: 1.011–1.033). However, we did not observe any associations between weekly exposure of PM10 and macrosomia.Our findings imply that the windows of susceptibility to PM2.5 and NO2 exposure on macrosomia are mainly in late pregnancy, whereas the windows of susceptibility to O3 exposure are in early and middle pregnancy.

Preimplantation genetic testing for a couple where the husband is affected by osteogenesis imperfecta combined with balanced translocation using karyomapping technique

To carry out preimplantation genetic testing (PGT) for a couple where the husband was affected by osteogenesis imperfecta combined with balanced translocation using the karyomapping technique. Blastocysts were detected using karyomapping, the carrier status of COL1A1 c.760G>A (p.Gly254Arg) variant and the carrier status of the translocated chromosome were analyzed simultaneously. For a total of 10 blastocysts, two euploid blastocysts were found to not carry the COL1A1 c.760G>A (p.Gly254Arg) variant but a balanced translocation. After transplanting one of the blastocysts, clinical pregnancy was achieved. Amniocentesis at 18th gestational week and prenatal genetic testing was in keeping with the result of PGT.A healthy female was born at 40+4 weeks gestation. For patients simultaneously carrying genetic variant and balanced chromosomal translocation, PGT can be performed with efficiency by the use of karyomapping method.