Amniotic Fluid Volume Research Articles

Incidence and Epidemiological Characters of Developmental Dysplasia of the Hip in Lianyungang: Based on Ultrasound Screening: A Retrospective Study.

To explore the incidence and epidemiological characteristics of developmental dysplasia of hip (DDH) in Lianyungang and provide a basis for early detection, early diagnosis and early treatment. Ultrasound screening was performed on aged 4-6 weeks to collect the incidence and epidemiological profiles of DDH. Graf hip ultrasound imaging was used for screening. DDH was diagnosed with a classification of ≥IIa-. Of the 9803 babies, 4999 were boys and 4687 were girls. There were 117 babies diagnosed with DDH, incidence rate of 1.19%. The incidence of DDH rate at left was higher than that at right (0.89%, 87/9803) vs (0.37%, 36/9803) and the difference was statistically significant (P < 0.001). Multivariate logistic regression analysis indicated that female (OR = 5.059, 95% CI: 3.012-9.109) and first child (OR = 1.871, 95% CI: 1.169-2.832) were the risk factors of DDH. Due to the small number of relevant cases and the absence of DDH cases, improper swaddling, abnormal amniotic fluid volume and confluent malformation could not be included for statistical comparison. The incidence of DDH in infants aged 4-6 weeks in Lianyungang was 1.19% (117/9803). DDH was more prone to occur on the left side. Girl and first-borns were the risk factors of DDH.

A Comparison of Amniotic Fluid Index versus Single Deepest Pocket Method in Terms of Maternal and Perinatal Outcome in Late Term Pregnancies

Background: Over diagnosis of isolated oligohydramnios is associated with increased obstetrical intervention without improving maternal and perinatal outcome. Objective of this study is to evaluate two methods of amniotic fluid volume assessment regarding obstetrical intervention frequency and its effect on maternal and perinatal outcome. Materials and Methods: This prospective study was conducted at a Private Hospital of Dera Ismail Khan and Khyber Teaching Hospital, Peshawar from 1st January 2017 till 31st December 2019. All pregnant patients with singleton, un-complicated pregnancy with period of gestation from 41 weeks to 41 weeks 6 days, live fetus were included in the study. Women who met the eligibility criteria were assigned to two different techniques of amniotic fluid assessment, first amniotic fluid index( AFI) method and second single deepest vertical pocket(SDVP) method. Data was recorded on a specially designed proforma. The socio-demographic variables were age in years, parity. Continuous variable was measured on numerical scale and expressed as mean and SD. Research variables were maternal outcome and perinatal outcome in terms of oligohydramnios frequency, induction of labour, caeserean section, fetal distress, NICU admission, A/S &lt; than 7 at 5 minutes. Chi-sq test of significance was applied. Results: A total of 160 patients met the inclusion criteria. In first group 30 (37.5%) and in second group18 (22.5%) had oligohydramnios. In AFI group 10 (33.3%) and in SDVP group 3(16.66%) had caesereans section. Induction of labour was 30(37.5%) in AFI group and 18(22.5%) in SDVP group. These results were statistically significant with a p value less than .05 at 5% significance level. Fetal distress, A/S &lt; than 7 at 5 minutes, NICU admission results were not statistically significant for two groups. Conclusion: SDVP technique gave less abnormal results, less intervention with no significant difference in maternal and perinatal outcome. Keywords: Amniotic fluid, Oligohydramnios, Caesarean section.

Correlation between the Duration of Premature Rupture of Membranes during the Labor and the Asphyxia of Newborn Babies at Aura Syifa Hospital Kediri Regency

Premature Rupture of Membranes (PROM) is rupture of membranes more than one hour before onset of labor. One of the complications caused by PROM is asphyxia. The longer the rupture of the membranes the greater the risk of fetal distress. By the rupture of the membranes the amniotic fluid volume decreases and there is an emphasis on the umbilical cord so that there is less supply of oxygen and nutrients to the fetus which causes the newborn to have asphyxia.The purpose of this study was to determine the correlation between the length of premature rupture of membranes during labor with asphyxia of the new born infant in Aura Syifa Kediri Hospital. This study used an observational research design with a Cross Sectional approach.

Chronic prenatal delta-9-tetrahydrocannabinol exposure adversely impacts placental function and development in a rhesus macaque model

Cannabis use in pregnancy is associated with adverse perinatal outcomes, which are likely mediated by the placenta. However, the underlying mechanisms and specific vasoactive effects of cannabis on the placenta are unknown. Our objective was to determine the impact of chronic prenatal delta-tetrahydrocannabinol (THC, main psychoactive component of cannabis) exposure on placental function and development in a rhesus macaque model using advanced imaging. Animals were divided into two groups, control (CON, n = 5) and THC-exposed (THC, n = 5). THC-exposed animals received a THC edible daily pre-conception and throughout pregnancy. Animals underwent serial ultrasound and MRI at gestational days 85 (G85), G110, G135 and G155 (full term is ~ G168). Animals underwent cesarean delivery and placental collection at G155 for histologic and RNA-Seq analysis. THC-exposed pregnancies had significantly decreased amniotic fluid volume (p < 0.001), placental perfusion (p < 0.05), and fetal oxygen availability (p < 0.05), all indicators of placental insufficiency. Placental histological analysis demonstrated evidence of ischemic injury with microinfarctions present in THC-exposed animals only. Bulk RNA-seq demonstrated that THC alters the placental transcriptome and pathway analysis suggests dysregulated vasculature development and angiogenesis pathways. The longer-term consequences of these adverse placental findings are unknown, but they suggest that use of THC during pregnancy may deleteriously impact offspring development.

A study on obstetric and perinatal outcome in a pregnancy complicated with oligohydramnios

Oligohydramnios, defined as when the AFI is less than 5. Definition of increased or decreased amniotic fluid volume are based on sonographic criteria. Oligohydramnios complicates approximately 1 to 2% of pregnancies Amniotic fluid provides the cushion effect against the constricting confines of the gravid uterus. It creates space and helps in musculoskeletal development of foetus, helps in normal fetal lung development and prevents compression of umbilical cord, placenta and hence protects the foetus from vascular and nutritional compromises. Oligohydramnios is associated with high risk adverse perinatal outcome like fetal distress, meconium aspiration, low APGAR, joint contracture, pulmonary hypoplasia etc., and associated with maternal morbidity in the form of increased rates of induction and/or operative interference. This study is conducted to find out the effects of oligohydramnios in determining the obstetric and perinatal outcome.To study, 1) Primary outcome- Obstetric outcome in terms of mode of delivery, indication for operative interference. 2) Secondary outcome- Neonatal outcome in terms of birth weight, Apgar score, colour of liquor, admissions to NICU. This is a prospective observational study conducted on 80 patients presenting to Department of Obstetrics and Gynecology at KIMS hospital, Bengaluru from January 2019 to June 2020 who were diagnosed with oligohydramnios with intact membranes with AFI&amp;#60;5cms using sonographic criteria. A total of 80 cases of Isolated Oligohydramnios were assessed. 38.7% cases delivered vaginally, 61.2% of cases underwent Cesarean section, 15% had meconium stained liquor, 15% had APGAR score of &amp;#60;7 at 1 minute, 42.5% had birth weight &amp;#60;2.5kgs and 37.5% of babies required NICU admissions. The present study was conducted to know the fetomaternal outcome in pregnancies with oligohydramnios. The study showed oligohydramnios was associated with higher rates of induction and Cesarean section and associated with Low birth weight babies.

The Effect of Amniotic Fluid Changes in Late Pregnancy on Maternal And Fetus Outcomes

The amniotic sac contains a protective liquid known as amniotic fluid. Two different types of amniotic fluid changes have been identified. The first is oligohydramnios, and the second is polyhydramnios. This study aimed to examine the effect of amniotic fluid changes on pregnancy outcomes and the fetus. A cross-sectional study was conducted by simple random sampling for, Four hundred fifty women from November 1st, 2021, until February28th 2022, in Duhok hospital for Obstetrics and Gynecology. The study revealed that the greatest rates of polyhydramnios were associated with gestational hypertension (22.7%) and gestational diabetes (19.3%). The most prevalent mode of delivery in all groups was cesarean section. Hypoglycemia had the greats incidence in polyhydramnios at (11.3%). There was a statistically significant association between amniotic fluid volume and baby gender, with males being more prevalent in oligohydramnios (58.7%) and polyhydramnios (57.3%) compared to normal amniotic fluid volume. Moreover, polyhydramnios had more effects on maternal and baby poor outcomes than oligohydramnios. Thyroid disease, diabetes mellitus, and hypertension were the most common types of chronic illnesses in polyhydramnios group compared with oligohydramnios group and normal amniotic fluid group. Apgar score, birth weight, congenital anomalies, hypoglycemia, asphyxia, and respiratory distress syndrome were statistically significant with oligohydramnios, polyhydramnios and normal amniotic fluid volum

TO ASSESS THE MATERNAL AND NEONATAL OUTCOME OF OLIGOHYDRAMNIOS AMONG THE ANC MOTHERS

Background : Oligohydramnios is a condition in which the amniotic fluid volume (AFV) is lower than usual for the gestational age. The volume of the amniotic fluid changes throughout pregnancy and increases linearly up to 34–36 weeks, which results in a reduced post-term gestation. This pattern facilitates fundal height measurements and pregnancy ultrasound analysis for the clinical evaluation of AFV. After the sonography has thoroughly scanned the belly, the largest vertical pockets of amniotic fluid can be seen that are free of the unborn child's body components or umbilical cord. Both single-fetal and multifetal gestations are considered to have oligohydramnios if the pocket is smaller than 2 cm. Objective : To assess the maternal and neonatal outcome of oligohydramnios among the ANC mothers. To associate the maternal and neonatal outcome of oligohydramnios among the ANC mothers with selected demographic variables. Research Design : Research Approach descriptive Research Approach. Setting of the study: the study was conducted at AVBR Hospital sawangi Meghe Wardha Population : ANC mothers. Sampling technique : simple random sampling .Sample size : 25. CONCLUSION : In order to analyse the maternal and newborn outcome of oligohydramnios among ANC moms, the researcher used a descriptive research design, which is examined in the section that follows the thorough analysis in this thesis. Under the headings of sepsis, perineal laceration, postpartum haemorrhage, premature membrane rupture, placental insufficiency, twin to twin transfusion syndrome, and cardiomyopathy, the mother outcome is broken down. Additionally, the neonatal outcome is broken down into the categories of low birth weight, APGAR scores at 1 and 5 minutes, reflexes, congenital anomalies, admission to the NICU, intrauterine growth restriction, birth asphyxia, foetal distress, delayed lung maturation, preterm birth, and stillbirth.The demographic characteristics did not significantly affect the maternal or neonatal outcome of oligohydramnios. As a result of the assessment and low levels of amniotic fluid found in this study, it is advised that all women increase their ANC visits in order to lower the risk of oligohydramnios in ANC mothers.

Monochorionic monoamniotic twin pregnancies.

Monochorionic monoamniotic (MCMA) twin pregnancy is rare and associated with increased complication rates when compared with singletons, dichorionic and monochorionic diamniotic pregnancy in general. Monoamnionicity presents an enormous challenge following its accurate diagnosis, where the absence of an inter-twin membrane subsequently results in cord entanglement and consistently fluctuating foetal position. Furthermore, the detection of twin-twin transfusion syndrome (TTTS) in MCMA pregnancy can be challenging in the absence of amniotic fluid volume discordance without the presence of the inter-twin dividing membrane. Early surveillance of foetal anatomy permits early recognition of foetal structural anomalies, the twin reversed arterial perfusion (TRAP) sequence and conjoined twins. However, the evidence on how best to monitor MCMA pregnancies remains inadequate, though observational studies have demonstrated that once surveillance is initiated, the potential risk of foetal death decreases significantly. In-utero foetal demise can be acute and unpredictable in MCMA pregnancies, despite close surveillance. Elective preterm delivery is usually advocated when the risk of foetal loss upon continuing the pregnancy outweighs the risk of prematurity - around 33 weeks' gestation by caesarean section. Nevertheless, the optimal prenatal surveillance regimen and prompts for delivery have yet to be defined.

A Study of Pregnancies Complicated by Decreased Amniotic Fluid with Maternal and Fetal Outcome in Combined Military Hospital Dhaka

Introduction: Decreased amniotic fluid volume below the normal range expected for the gestational age is a challenging entity encountered by obstetricians. Normal range of amniotic fluid is Amniotic Fluid Index (AFI) 8-20cm. Amniotic Fluid Index (AFI) is a quantitative estimation of amniotic fluid volume seen and measured by ultrasonography during pregnancy. AFI is the sum of the deepest vertical pocket of fluid, excluding fetal parts and umbilical cord, in four quadrants between the maternal midline vertically and transverse line half way between the pubic symphysis and uterine fundus. Decreased AFI has different etiology, pathophysiology, presentation and effect on fetomaternal outcome. Objectives: To assess the incidence, aetiology, time and mode of delivery as well as to evaluate fetomaternal outcome associated with decreased amniotic fluid. Materials and Methods: Prospective observational study was carried out among 60 cases of pregnancy at 3rd trimester with decreased amniotic fluid index admitted in the Department of Obstetrics and Gynaecology, Combined Military Hospital, Dhaka Bangladesh from October 2012-March 2013. Amniotic fluid index was determined by the four quadrant ultrasonography technique on admission. Variables used are parity, gestational age, AFI, the colour of amniotic fluid, etiology and mode of delivery. Neonatal outcome variables were birth weight, APGAR scores at Iand 5 minutes and admission to the neonatal intensive care unit. Results: This study showed that 6% of the admitted patients were presented with decreased amniotic fluid. Among them 42% were borderline and 58% were severe oligohydramnios. Termination by caesarean section is high especially among the severe oligohydramnios patients 29 of 34. High rate of caesarean section is primarily due to fetal distress 60%. There was no maternal morbidity but there was 32% fetal morbidity. Conclusion: Decreased amniotic fluid volume has no significant effect or maternal morbidity other than increased rate of caesarean section, however there was significant neonatal morbidity mainly due to birth asphyxia, others are neonatal sepsis and meconium aspiration syndrome. JAFMC Bangladesh. Vol 18, No 1 (June) 2022: 67-70

A Clinical Study on Maternal and Perinatal Outcome of Oligohydramnios

Background : Oligohydramnios is one of the pregnancy associated common complications facing by obstetrician which is associated with adverse maternal and perinatal outcome such as birth defects, miscarriage, intrauterine growth restriction, still birth, preterm birth, increased operative interference etc. Objective: To assess the impact of oligohydramnios on maternal and perinatal outcome. Methods: This cross-sectional descriptive study was conducted at Department of Obstetrics and Gynecology, BSMMU, Dhaka from October 2017 to March 2018.Total 50 patients were enrolled by purposive sampling method according to the inclusion and exclusion criteria. Clinical evidence of oligohydramnios was looked for &amp; confirmed by ultrasonography (USG). Based on Amniotic fluid index (AFI)measurements patients were divided into two groups. Those who have AFI &lt;5cm and 5-8cm. The significance of difference or comparison of means was measured by Chi square test. Maternal and perinatal outcome in pregnancies with oligohydramnios were compared with those with 5-8cm amniotic fluid volume. Results: The mean age of the study population was 23.3±4.06 years and majority of the cases were multipara (56%) and presented at term (58%). Borderline oligohydramnios (AFI 5-8cm) was found in 74% cases and severe oligohydramnios (AFI &lt;5cm) were found in 26% cases. Most common etiological factor was idiopathic. Fifteen cases (30%) had vaginal delivery and caesarean section rate 70%, no maternal mortality occurred in this study, perinatal mortality rate was 10%, low birth weight baby was 63.6% and NICU admission rate was 53.8%. Conclusion: An antepartum or intrapartum oligohydramnios is associated with significantly increased incidence of caesarean section for fetal distress and increased incidence of low-birth-weight babies and increased rate of neonatal complications. Northern International Medical College Journal Vol. 12 No.1 July 2020, Page 489-492

Combination of Doppler measurements with amniotic fluid volume for the prediction of perinatal outcomes in fetal growth restriction.

We aimed to evaluate a new ratio of amniotic fluid volume (AFV) to Doppler measurements, and compare its association with adverse perinatal outcomes (APOs) in fetal growth restriction (FGR). This prospective study included pregnant women with singleton fetal growth-restricted fetuses. Each participant underwent a detailed ultrasonographic examination. Uterine artery pulsatility index, umbilical artery pulsatility index (UA PI), middle cerebral artery pulsatility index (MCA PI), cerebroplacental ratio (CPR), and umbilical-to-cerebral ratio (UCR) were calculated, and the single deepest pocket (SDP) technique was used to estimate AFV. Amniotic-umbilical-to-cerebral ratio (AUCR) was calculated as the ratio of SDP to UCR: AUCR=SDP / (UA PI/MCA PI). APO was defined as umbilical venous cord blood pH <7.10, 5-minute APGAR score <7, and neonatal intensive care unit admission. We compared the fetal ultrasonographic and demographic features between the APO and the non-APO groups. The mean UA PI and UCR were significantly higher in the APO group. The mean SDP, CPR, and AUCR were significantly lower in the APO group. Receiver operating characteristic curve analyses demonstrated the highest area under the curve value (0.882; P < 0.001) for AUCR to APOs. The current study suggests that AUCR is the best predictor for APOs in FGR.

Accuracy of the sonographic determination of estimated fetal weight in anhydramnios.

To determine whether the presence of anhydramnios significantly influences the sonographic estimated fetal weight (EFW) compared to a matched cohort with normal amniotic fluid volume. The study sample of this retrospective case-control study consisted of 114 pregnant women who presented to a Tertiary Perinatal Clinic between 2015 and 2020. 57 of them presented with an anhydramnios and a matched cohort of 57 women with normal amniotic fluid volume. At time of admission, gestational age varied between 22 +4 and 42 +6weeks of pregnancy. All women underwent detailed ultrasound assessment for EFW and amniotic fluid index. To determine EFW Hadlock's estimation formula I was used which is based on measurements of biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL). The EFW was compared with the weight at delivery. The maximum time interval between measurement and delivery was 5days. There was neither a significant difference between the case and control group with regard to gestational age at ultrasound in days (median 249days and 246days, p = 0.97), nor to gestational age at birth (median 249days and 247days, p = 0.98). Concerning the newborns parameters, the body length at birth was not significantly different between the case and control group in centimeters (cm) (median 47cm and 47cm, p = 0.79). EFW in gram (g) was lower than birth weight in both groups and did not differ significantly between case and control group (estimated weight median 2247g and 2421g, p = 0.46; birth weight median 2440g and 2475g, p = 0.47). The difference between EFW and birth weight in percent (%) did not differ between the case and control group (median -3.9% and -5.6%, p = 0.70). The maternal parameters showed that the patients in the case group were younger (median 31years and 38years p = 0.20) and had a significantly higher body mass index (BMI) (median 27.3kg/m2 vs 22.0kg/m2, < 0.001) compared to the control group. Our study shows for the first time that EFW in women with anhydramnios can be determined sonographically just as accurately as in a matched cohort with normal amniotic fluid volume. A reliable estimation of fetal weight is crucial for optimal assessment of the newborns prognosis and counseling of the parents especially when advising women in the early weeks of pregnancy at the limit of viability.

Amniotic fluid characteristics and its application in stem cell therapy: A review.

Amniotic fluid (AF) is a clear yellow fluid that surrounds the fetus during pregnancy. The amniotic sac consists of 2 layers: the amnion and the chorion. Osmotic and hydrostatic forces cause the maternal plasma to pass through the fetal skin and generate the AF. AF allows the fetus to grow inside the uterus, supports it from injuries, retains consistent pressure and temperature, and enables the exchange of body chemicals with the mother. At first, it consists of water and electrolytes but after the 12-14 wk the liquid also contains carbohydrates, proteins, lipids, phospholipids, urea, hormones, and some biochemical products. AF appearance is characterized by the grade of cloudiness and the number of flakes of the vernix. The volume of AF increases with the fetus's growth. Its appearance depends on the gestational age. In addition to differentiated cells, stem cells are also found within the AF. These cells express embryonic-specific cell markers and bear high self-renewal capacity and telomerase activity. AF stem cells possess the potential to differentiate into osteogenic, cardiac, skeletal muscle, lung, neuronal, kidney, bone, cartilage, ovarian and hepatic cells in vitro. They represent a great promise in regenerative medicine for the reconstruction of bio-artificial tissues and organs in vivo. The purpose of this paper was to briefly review the development and function of AF and the application of its stem cells in cell therapy.

Developing Clinical Artificial Intelligence for Obstetric Ultrasound to Improve Access in Underserved Regions: Protocol for a Computer-Assisted Low-Cost Point-of-Care UltraSound (CALOPUS) Study.

BackgroundThe World Health Organization recommends a package of pregnancy care that includes obstetric ultrasound scans. There are significant barriers to universal access to antenatal ultrasound, particularly because of the cost and need for maintenance of ultrasound equipment and a lack of trained personnel. As low-cost, handheld ultrasound devices have become widely available, the current roadblock is the global shortage of health care providers trained in obstetric scanning.ObjectiveThe aim of this study is to improve pregnancy and risk assessment for women in underserved regions. Therefore, we are undertaking the Computer-Assisted Low-Cost Point-of-Care UltraSound (CALOPUS) project, bringing together experts in machine learning and clinical obstetric ultrasound.MethodsIn this prospective study conducted in two clinical centers (United Kingdom and India), participating pregnant women were scanned and full-length ultrasounds were performed. Each woman underwent 2 consecutive ultrasound scans. The first was a series of simple, standardized ultrasound sweeps (the CALOPUS protocol), immediately followed by a routine, full clinical ultrasound examination that served as the comparator. We describe the development of a simple-to-use clinical protocol designed for nonexpert users to assess fetal viability, detect the presence of multiple pregnancies, evaluate placental location, assess amniotic fluid volume, determine fetal presentation, and perform basic fetal biometry. The CALOPUS protocol was designed using the smallest number of steps to minimize redundant information, while maximizing diagnostic information. Here, we describe how ultrasound videos and annotations are captured for machine learning.ResultsOver 5571 scans have been acquired, from which 1,541,751 label annotations have been performed. An adapted protocol, including a low pelvic brim sweep and a well-filled maternal bladder, improved visualization of the cervix from 28% to 91% and classification of placental location from 82% to 94%. Excellent levels of intra- and interannotator agreement are achievable following training and standardization.ConclusionsThe CALOPUS study is a unique study that uses obstetric ultrasound videos and annotations from pregnancies dated from 11 weeks and followed up until birth using novel ultrasound and annotation protocols. The data from this study are being used to develop and test several different machine learning algorithms to address key clinical diagnostic questions pertaining to obstetric risk management. We also highlight some of the challenges and potential solutions to interdisciplinary multinational imaging collaboration.International Registered Report Identifier (IRRID)RR1-10.2196/37374

Maternal Fasting Blood Glucose, Blood Pressure, and Amniotic Fluid Volume with Baby Birth Length and Weight

Maternal health during pregnancy is affecting fetal health in the womb and after birth. This study was conducted to see how maternal fasting blood glucose, blood pressure, and amniotic fluid volume in third semester correlate with baby birth weight and length. The design of this research was observasional in cohort program from third trimester pregnancy until delivery. Result showed that the rising of maternal fasting blood glucose in third trimester was predicted to significantly increasing the baby’s birth weight (b= 7,24, p= 0,025). Inversely, the increase in blood pressure during pregnancy had the potential to lower the weight of the baby (b= -13,94, p= 0,058) although not significanty proven in this study. The correlation between maternal amniotic fluid volume had not shown significant results with neither birth length nor weight of the offspring in this study. It is recommended that pregnant women could maintain their health and also conducted regular health checks of blood glucose, blood pressure, and amniotic fluid volume to avoid pregnancy adverse outcomes if detected.

Pregnant woman infected with SARS-COV-2 – diagnosis and treatment

Introduction: COVID-19 is an infection caused by the new SARS-CoV-2 virus. In pregnant women with COVID-19, compared to non-pregnant women, there is an increased risk of a severe course of the infection. Pregnant women are more often hospitalized in the Intensive Care Unit and require mechanical ventilation. In the course of COVID-19 infection, pregnant women have a greater risk of miscarriage, premature birth or having a baby with low birth weight, compared to their healthy pregnancy peers.&#x0D; The aim of the study: To present, based on the available literature, the principles of management of a pregnant woman infected with SARS-CoV-2 virus.&#x0D; State of knowledge: The evidence of infection is the detection of the virus in the clinical specimen confirmed by PCR. Chest computer tomography can be useful in diagnosis, especially when the PCR test result is negative. Particular attention should be paid to pharmacological treatment, which should be both effective and safe for the fetus. Certain antiviral and anti-inflammatory drugs as well as anticoagulants drugs are used in COVID-19 therapy. Oxygen and fluid therapy is also important. The condition of the fetus should be monitored regularly. It is recommended to measure the fetal heart rate, perform cardiotocography, pregnancy ultrasound and assess the volume of amniotic fluid. The decision about the time and method of delivery should be made individually on the basis of obstetric indications and the maternal-fetal condition.&#x0D; Summary: The therapy of a pregnant patient infected with SARS-CoV-2 should be adjusted individually depending on the woman's health condition. In therapeutic interventions, the welfare of both the mother and the fetus should be taken into account.

Increased fetal epicardial fat thickness: A reflecting finding for GDM and perinatal outcomes.

To study the value of fetal epicardial fat thickness (EFT) in gestational diabetes mellitus in the third trimester of pregnancy and its relationship with clinical parameters and perinatal outcomes. A total of 80 participants, including 40 with diagnosed GDM and 40 healthy pregnant women, were included in the study. Demographic data were obtained from medical records. Sonographic examinations were performed, such as amniotic fluid value, fetal biometric measurements, and Doppler parameters of the umbilical artery. Fetal EFT values were measured at the free wall of the right ventricle using a reference line with echocardiographic methods. Correlation tests were performed to evaluate the relationship between fetal EFT and clinical and perinatal parameters. p<.05 were interpreted as statistically significant. The fetal EFT value was statistically higher in the GDM group than in the control group (p: .000). Spearman and Pearson correlation tests revealed statistically significant but weak positive correlations between fetal EFT value, 1-h 100-g OGTT, birth weight, and BMI (r: .198, p: .047; r: .395, p: .012; r: .360, p: .042, respectively). The optimal fetal EFT threshold for predicting GDM disease was found as 1.55mm, with a specificity of 74.4% and sensitivity of 75.0%. Statistically significant differences between the two groups in umbilical artery Doppler resistance index (RI), pulsatility index (PI), and systolic/diastolic ratio (S/D) were not found (p: .337; p: .503; p: .155;). BMI and amniotic fluid volume were higher in the GDM group compared to the control group (p: .009; p<.01). This study demonstrated that increased fetal EFT may occur as a reflection of changes in glucose metabolism in intrauterine life. Future studies with larger series, including the study of neonatal metabolic parameters, will contribute to the understanding of the importance of fetal EFT in determining the metabolic status of the fetus.

Sonography Assessment of Amniotic Fluid Volume as a Predictor of Fetal Outcome in Low-Risk Pregnancy

Sonography Assessment of Amniotic Fluid Volume as a Predictor of Fetal Outcome in Low-Risk Pregnancy

Maternal and Perinatal Risk Factors for Infantile Hemangioma: A Matched Case-Control Study with a Large Sample Size.

IntroductionInfantile hemangioma (IH) is the most common benign tumor in infancy, but information about its pathogenesis is limited. The aim of this study was to determine maternal and perinatal risk factors for IH.MethodsA total of 1033 IH patients were enrolled in the study between 2017 and 2020. IH patients were matched with controls by sex. Trained investigators collected detailed information from the participants. Logistic regression models were used for multivariate analysis.ResultsThe statistical analysis demonstrated that miscarriage history (odds ratio [OR] = 4.275; 95% confidence interval [CI] [3.195, 5.720]), anemia in pregnancy (OR = 4.228; 95% CI [3.083, 5.799]), preterm premature rupture of membranes (PPROM) (OR = 3.182; 95% CI [1.359, 7.454]), placenta previa (OR = 2.440; 95% CI [1.787, 3.333]), threatened miscarriage (OR = 2.290; 95% CI [1.726, 3.039]), premature rupture of membranes (PROM) (OR = 1.785; P < 0.05), progesterone use (OR = 1.614; P < 0.001) and abnormal amniotic fluid volume (OR = 1.499; P < 0.05) were independent risk factors for IH. Gestational diabetes mellitus (GDM) (OR = 0.607; 95% CI [0.464, 0.794]), multiple gestations (OR = 0.407; 95% CI [0.232, 0.713]), hypothyroidism (OR = 0.407; 95% CI [0.227, 0.730]) and uterine fibroids (OR = 0.393; 95% CI [0.250, 0.618]) may reduce the risk of IH.ConclusionsMaternal and perinatal factors are closely associated with IH occurrence. Our study provides reliable clues to guide further exploration of the pathogenesis of IH.Trial RegistrationClinicalTrials.gov, NCT03331744.Plain Language SummaryInfantile hemangioma is the most common benign tumor in children, which seriously affects appearance and function and even threatens life. The pathogenesis is not clear, a detailed case-control study of the maternal and perinatal periods with a large sample size will facilitate the development of individualized and precise treatment, early and timely interventions for high-risk children and improvement of prognosis. Our study found that miscarriage history, anemia in pregnancy, preterm premature rupture of membranes (PPROM), placenta previa, threatened miscarriage, premature rupture of membranes (PROM), progesterone use and abnormal amniotic fluid volume were independent risk factors for IH.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13555-022-00756-4.

Amniotic Fluid Classification and Artificial Intelligence: Challenges and Opportunities.

A fetal ultrasound (US) is a technique to examine a baby’s maturity and development. US examinations have varying purposes throughout pregnancy. Consequently, in the second and third trimester, US tests are performed for the assessment of Amniotic Fluid Volume (AFV), a key indicator of fetal health. Disorders resulting from abnormal AFV levels, commonly referred to as oligohydramnios or polyhydramnios, may pose a serious threat to a mother’s or child’s health. This paper attempts to accumulate and compare the most recent advancements in Artificial Intelligence (AI)-based techniques for the diagnosis and classification of AFV levels. Additionally, we provide a thorough and highly inclusive breakdown of other relevant factors that may cause abnormal AFV levels, including, but not limited to, abnormalities in the placenta, kidneys, or central nervous system, as well as other contributors, such as preterm birth or twin-to-twin transfusion syndrome. Furthermore, we bring forth a concise overview of all the Machine Learning (ML) and Deep Learning (DL) techniques, along with the datasets supplied by various researchers. This study also provides a brief rundown of the challenges and opportunities encountered in this field, along with prospective research directions and promising angles to further explore.