Fetal Body Research Articles

Combined prenatal US and post-mortem fetal MRI: can they replace conventional autopsy for fetal body abnormalities?

The acceptance of conventional autopsy (CA), the gold standard method for investigating fetal death, often remains problematic. Post-mortem magnetic resonance imaging (PMMRI) is increasingly advocated, particularly for neurologic malformations. However, PMMRI performances to diagnose non-neurologic malformations remain unclear. We aim to clarify whether a full body CA remains needed after prenatal ultrasound (US) and PMMRI in assessing non-neurologic fetal malformations. In this retrospective IRB-approved study, during a 6-year period, all fetuses who underwent PMMRI, prenatal US, and full body CA were included. Body abnormalities were identified in US, PMMRI, and CA reports. US and PMMRI images were all reviewed. All abnormalities were graded as major (2 points) or minor (1 point). Each technique (US, PMMRI, CA) was given a score by adding all grading points. In each fetus, results were compared for both separate and combined US and PMMRI to CA. Sensitivity and specificity were calculated for detecting major abnormalities. Fifty fetuses were included. The score of CA, US, and PMMRI was respectively 53, 37, and 46. Compared with US-PMMRI, CA added information in 2 cases (4%) with major abnormalities and 7 cases (14%) with minor abnormalities. PMMRI and US were concordant in 36/50 (72%) fetuses. Separate US/PMMRI sensitivities and specificities for detecting major body malformations respectively were 80%/80% and 100%/94%. Combined US-PMMRI had a sensitivity of 90% and a specificity of 94%. Two cardiac malformations (2/6) were only described by CA. After prenatal US and PMMRI, few additional fetal body malformations are discovered with CA. Nevertheless, fetal heart autopsy remains mandatory. A cardiac conventional autopsy complemented by prenatal ultrasound and post-mortem MRI allows to detect all major fetal body abnormalities. With this efficient and much less invasive approach, a higher acceptance rate of fetal autopsy can be expected. • Excepting cardiac malformations, most major fetal body malformations can reliably be identified by prenatal US combined with post-mortem MRI. • In the post-mortem diagnosis of fetal body malformations, a conventional autopsy limited to the fetal heart might replace a full body autopsy after a well-conducted prenatal US and post-mortem MRI.

Assessment of Teratogenic Effects of Sappan Wood (Caesalpinia Sappan L.) Extract In Rats (Rattus novergicus)

Treatment using plant materials has been widely researched and observed to assist in curing a disease. Medicinal products derived from herbal plants are proven useful as drugs must follow guidelines not to cause acute or chronic toxicity. The purpose of this study was to investigate the teratogenic potential of an ethanolic sappan wood extract on the growth of unborn rats. Six groups of pregnant rats are created: Aquadest was administered to the Control group, whereas the Treatment groups received 100, 200, 300, 400, or 500 mg.kg-1 BW of an ethanolic extract of Sappan wood. On the twenty-first day of gestation, pregnant rats were CO2-euthanized and delivered vaginally. Rats' body weight during pregnancy was observed, along with fetal growth measurements, viscoelastic examination, and skeletal development. Wistar rats' reproductive systems, fetal body weight, body length, and tail length were all unaffected by ethanol extract of Sappan wood at doses from 100 mg/kg to 500 mg/kg. In fetuse rat from the control group and the five dosage groups, no skeletal development had taken place and there were no obvious external abnormalities. Even at the maximum dose of 500 mg, sappan wood extract demonstrated no teratogenic effects on the development of fetal rats.kg-1 BW.

OECD 414 supplementary prenatal developmental toxicity study of sodium molybdate dihydrate in the rat and benchmark dose evaluation

In a continuing investigation of the potential for reproductive and developmental toxicity of molybdenum (Mo), consequent to the previous published OECD studies [1,2] and as directed by the European Chemicals Agency [3], a supplemental rat GLP-compliant Prenatal Developmental Toxicity (PNDT) study was conducted to investigate higher dose levels of sodium molybdate dihydrate (SMD) in an identical study design (OECD 414)[4] to Murray et al. 2014a [1], at dietary concentrations calculated to provide target Mo levels of 80 and 120 mg/kg bw/day (the maximum-tolerated dose). There was no effect on post-implantation loss, litter size, sex ratio or the incidence of external, visceral or skeletal fetal malformations or variations. Fetal weight was reduced proportionate to maternal dose. Minimal differences observed in the ossification status of some extremities of fetuses from females receiving 120 mg Mo/kg bw/day were confirmed as transient by skeletal examination of PND 21 pups from a further group of females receiving the same dose regime. There was no evidence of copper depletion in serum, placenta or liver. A benchmark dose evaluation using continuous and dichotomous approaches by combining the fetal body weight data from this study and the previous study determined that the BMD05 ranged from 47 to 57 mg Mo/kg bw/day, depending on the modelling approach and the BMDL05 estimates ranged from 37 to 47 mg Mo/kg bw/day. These levels are considered a more statistically robust point of departure for risk assessment for reproductive effects than the established NOAEL of 40 mg Mo/kg bw/day.

Pharmacological Action of Baicalin on Gestational Diabetes Mellitus in Pregnant Animals Induced by Streptozotocin via AGE-RAGE Signaling Pathway.

Baicalin (BC) is a flavonoid reported to have various pharmacological activities, including antioxidant, anti-cancer, anti-inflammatory, anti-allergy, immune regulation, and anti-diabetic. This study examines the probable mechanism for gestational diabetes mellitus (GDM) brought on by streptozotocin (STZ) and the impact of BC on fetal development via AGEs (advanced serum glycation end products) and RAGE (the role of advanced glycation end products). STZ has been used in the current experimental study to induce diabetes mellitus in pregnant animals (gestational diabetes mellitus). GDM pregnant animals were separated into five groups and were treated with BC in a dose-dependent pattern for 19days. At the end of the experiment, the fetus and blood samples were drawn from all the pregnant rats to assess the biochemical parameter as well as AGE-RAGE. Administration of BC at varying doses leads to enhancement in the weight of the fetus body and placenta while gestational diabetic pregnant animals induced by STZ had a lower weight of the fetus body and placenta. The dose-dependent pattern of BC also enhanced fasting insulin (FINS), high-density lipoprotein (HDL), serum insulin, and hepatic glycogen. It also significantly enhanced the content of the antioxidant profile and pro-inflammatory cytokines and modulated the gene expression (VCAM- 1, p65, EGFR, MCP-1, 1NOX2, and RAGE) in various tissues in gestational diabetes mellitus pregnant rats. Baicalin demonstrated the potential impact on the embryo's development via the AGE-RAGE signaling pathway in STZ-induced GDM pregnant animals.

Analysis of characteristic features in ultrasound diagnosis of fetal limb body wall complex during 11-13+6 weeks.

Limb body wall complex (LBWC) is a fatal malformation characterized by major defects in the fetal abdominal or thoracic wall, visceral herniation, significant scoliosis or spina bifida, limb deformities, craniofacial deformities, and umbilical cord abnormalities (short or absent umbilical cord). Early diagnosis of this condition is of great clinical significance for clinical intervention and pregnancy decision-making. With the rapid development of fetal ultrasound medicine, early pregnancy (11-13+6 wk) standardized prenatal ultrasound examinations have been widely promoted and applied. To explore the value of prenatal ultrasound in the diagnosis of fetal LBWC syndrome during early pregnancy. The ultrasonographic data and follow-up results of 18 cases of fetal LBWC diagnosed by prenatal ultrasound during early pregnancy (11-13+6 wk) were retrospectively analyzed, and their ultrasonographic characteristics were analyzed. Among the 18 fetuses with limb wall abnormalities, there were spinal dysplasia (18/18, 100%), varying degrees of thoracoschisis and gastroschisis (18/18, 100%), limb dysplasia in 6 cases (6/18, 33%), craniocerebral malformations in 4 cases (4/18, 22%), thickening of the transparent layer of the neck in 5 cases (5/18, 28%), and umbilical cord abnormalities in 18 cases (18/18, 100%), single umbilical artery in 5 cases. Prenatal ultrasound in early pregnancy can detect LBWC as early as possible, and correct prenatal evaluation provides important guidance value for pregnancy decision-making and early intervention.

Amelioration of silymarin against cadmium-induced toxicity in pregnant rats and their fetuses.

Silymarin is an antioxidant without side effects even at relatively high physiological dosage. Therefore, it is safely used as a herbal medicine for treating different diseases. The purpose of this study was to examine the toxicity of cadmium (Cd) in pregnant rats and their fetuses and the ameliorative effects of silymarin (SL) against this toxicity. A total of 24 pregnant rats allocated into four equal groups. Control, silymarin (200 mg/kg), Cd (5 mg/kg), and a combination of Cd and silymarin concurrent from 6 to 20th gestational day. Number of corpora lutea, dams', gravid uteri, placental weights, and likewise fetal body weights and lengths were analyzed as physical parameters. Serum levels of aspartate transaminase, alanine transaminase, creatinine, urea, uric acid, and maternal and fetal liver tissues for malondialdehyde, superoxide dismutase, catalase and glutathione activity were studied. The histology of hepatic and renal tissues for both mothers and fetuses was examined. Data were statistically analyzed by analysis of variance test and Duncan's multiple range test was used to compare group means. The findings evidenced that Cd causes teratogenic abnormalities and histopathological variation in hepatic and renal tissues of both mothers and fetuses. Cd triggers oxidative stress and disrupts liver and kidney function. In Cd + silymarin treated rats exhibited improvement in the pregnancy outcomes, reduced histopathological changes, oxidative stress as well as liver and kidney enzymes. We deduced that using of silymarin during gestation is effective and ameliorate the toxic maternal complications caused by cadmium.

Amniotic Band Syndrome – A Case Report

Amniotic Band Syndrome (ABS) encompasses a wide spectrum of abnormalities, all of which result from the entrapment of various parts of the fetal body in the disrupted amniotic fluid. Because of the randomness of entrapment, each affected individual has the potential to develop a unique deficit. Termination of pregnancy is usually suggested at the time of diagnosis of severe abnormalities, while minor limb defects can be repaired by surgery after birth [1]. Here we report a case of amniotic band syndrome detected during fetal anomaly scan at 19w0d gestational age

Characterization of ultrasound and postnatal pathology in fetuses with heterotaxy syndrome.

To explore the diagnostic clues and abnormality spectrum of heterotaxy syndrome by prenatal ultrasonography and postnatal verification. The prenatal ultrasonic data of 88 heterotaxy syndrome fetuses were analyzed retrospectively as left isomerism (LI) and right isomerism (RI). Prenatal ultrasound compared with the anatomical casting of the fetal body after labor induction, and the confirmatory postnatal diagnosis after delivery. Fetal LI showed typical malformations of gastric vesicles on different sides from the heart, absence of hepatic segment of the inferior vena cava (IVC), abdominal aorta (AO) parallel with the azygos vein (AV), bilateral left bronchus, bilateral left atrial appendages, and polysplenia; intracardiac malformations of AV septal defects (AVSD), single atrium (SA), left ventricular outflow tract obstruction (LVOTO), and double-outlet right ventricle (DORV); and cardiac conduction abnormalities of sinus bradycardia and AV blockage. Fetal RI reported typical malformations of gastric vesicles on different sides from the heart, juxtaposition of the IVC with AO, anomalous pulmonary venous connection (APVC), asplenia, and bilateral right atrial appendages; intracardiac malformations of AVSD, SA, single ventricle, pulmonary atresia and stenosis, and DORV. The postnatal verification revealed 3 malformations misdiagnoses and 4 malformations missed diagnoses in LI fetuses and 10 misdiagnoses and 8 missed diagnoses in RI fetuses. The proposed five-step prenatal ultrasonography has an important diagnostic value for the identification and classification of heterotaxy syndrome. The different sides of gastric vesicles and cardiac apex are important diagnostic clues for heterotaxy syndrome, featuring disconnected or hypoplastic IVC, typical complex cardiac malformation, and atrioventricular block in fetal LI, and shown APVC, juxtaposition of IVC and AO, and intracardiac malformations such as AVSD, DORV, and LVOTO in fetal RI.

Diagnosis of Non-Immune Hydrops Foetalis and Cystic Hygroma in a 20-Week Foetus: A Case Report

Hydrops foetalis (HF) is the excessive fluid accumulation in at least two foetal body cavities, including pleural, pericardial, and peritoneal cavities, with associated soft tissue oedema. Most cases of hydrops foetalis were due to severe erythroblastosis foetalis, secondary to Rhesus isoimmunization. However, other variants include non-immune hydrops foetalis (NIHF). Foetal cystic hygroma, which occurs due to lymphatic obstruction, is commonly associated with immune hydrops foetalis (IHF). A combination of the conditions in a foetus tends to portend an abysmal prognosis because it can lead to abortion, intrauterine foetal death (IUFD) and early neonatal death (ENND). We report a case of a 22-year-old woman with a prenatal ultrasound diagnosis of a combination of NIHF and foetal cystic hygroma at 20 weeks of gestation. Therefore, there is a need for early diagnosis of the anomalies so that early termination of pregnancy can be performed if the patient desires.

Studies on teratogenic and maternal effects of Trichothecene (TCT) extracted from Fusarium and Trichoderma culture on pregnant Albino Mice

Mycotoxins (frequently referred to as secondary metabolites of toxigenic fungi) are commonly found in foodstuffs and are essential because of their association with disease. The current study investigated the teratogenic potential characteristics of T-2 trichothecenes mycotoxins produced by Fusarium and Trichoderma, which are reportedly toxic to humans and animals in pregnant mice. T-2 toxin is a cytotoxic secondary fungal metabolite that belongs to the trichothecene mycotoxin family. T2 was administered intraperitoneally to Pregnant females as a single injection at levels of 50, 75,100, and 125 ppb on one of the gestation days 7-11 during the pregnancy period. A significant reduction in mean fetal body weight and various fetal malformations (i.e., external and skeletal) were observed following maternal exposure to T2. This is the first report to implicate this mycotoxin T -2 as a teratogen in our region. Our study revealed that T-2 toxin 125 ppm exposure was enough to cause abortion in pregnant mice within several days. Keywords: T2 toxin, trichothecenes, mycotoxins, fungi, pregnant mice

Physiological assessment of the fetal body using MRI: current uses and potential directions.

MRI assessment of the fetus using fast T2-weighted sequences is well established in defining alterations in fetal anatomy and structure, as a biomarker for disease, and in some cases prognostication. To date, the physiological assessment of the fetus using advanced sequences to characterise tissue perfusion and microarchitecture has largely been unused. Current methods of assessing fetal organ function are invasive and carry inherent risk. Therefore, the identification of imaging biomarkers of altered fetal physiology, and correlation with postnatal outcome, is attractive. This review describes the techniques which show promise for such a task and potential future directions.

Longitudinal Study to Assess the Reliability and Predictive Validity of Ultrasound Measurements in Tracking Fetal Growth and Development Throughout Pregnancy

The utilization of ultrasound in obstetrics is extremely common due to its accurate fetal imaging capabilities. By early identifying anomalies such intrauterine growth restrictions and macrosomia, ultrasonography scanning during pregnancy primarily aims to reduce the risk of obstetric problems. Fetal weight is currently estimated using morphometric formulas. They employ fundamental biometric variables. Hadlock's formula, which is used for estimation of fetal weight, has 20 percent error rate, though. Due to this particular cause, the researchers from all around world had already searching for the additional sonographic characteristics having a stronger predictive value that correlate with fetal weight. According to recent scientific studies, assessing fetal weight can benefit from using novel parameters of sonograph such measurements of the thickness of soft tissue. The fetus's body can be measured in a number of locations, including upper arm, the thigh, abdomen, and the subscapular region. Diverse measurements have varying degrees of connection with some other anthropometric & sonographic factors, including body mass & gestational age. Numerous research using novel formulas for calculating fetal weight have been produced in response to the reports. For measuring fetal weight, measurements other than those including soft tissue, including such those lean and adipose tissue or utilising 3D ultrasonography are acquired. For the purpose of sonographic pregnancy assessment, ultrasound examination of the thicknesses of subcutaneous tissue in the several body regions might evidence to become reliable indicator of the fetal weight. Keywords: Pregnancy, postpartum hypoglycaemia, foetus, Intra-uterine, pregnancy ultrasound

Influence of radiation exposure to delayed fetal growth in wild Japanese monkeys after the Fukushima accident.

Wild Japanese monkeys (Macaca fuscata) were exposed to radiation after the Fukushima Daiichi nuclear accident in 2011. To clarify the biological effects of radiation exposure on their fetal growth, pregnant monkeys and their fetuses were analyzed. These animals were collected between 2008 and 2020 (before and after the accident in 2011) living in Fukushima City, approximately 70 km from the nuclear power plant. Multiple regression analyses were conducted with fetal body weight (FBW) and fetal head circumference (FHS) as objective variables, and maternal and fetal factors as explanatory variables. The maternal factors were relative exposure dose rate (REDR), age, body weight, body length, fat index, and parity. The fetal factors were crown ramp length (CRL) and sex. Multiple regression analyses showed that FBR and FHS growth were positively associated with CRL, maternal body length, and negatively associated with REDR. Since the relative growth of FBR and FHS to CRL decreased with increasing REDR, radiation exposure due to the nuclear accident may have contributed to the delayed fetal growth observed in Japanese monkeys.

Measurement of the Fetal Ear Length Has No Clinical Value.

The long-term monitoring of a fetus with genetic and non-genetic anomalies is still a challenge for prenatal medicine. Ultrasound screening must be based on some measurement ranges, which show the trend of development of fetal body parts in a given period of time. One of them is the fetal ear auricle. This study presents an analysis of the fetal ear auricle length in healthy fetuses to establish normal ranges of fetal ear auricle length. The study group included 132 healthy fetuses. The gestational age of healthy fetuses ranged from 17.0 to 39.5 weeks of gestation according to LMP. The range of fetal ear length measurement was 10.00-40.00 mm with an average value of 23.49 mm. In the group of fetuses in the second trimester of pregnancy, the range of fetal ear length measurement was 18.00-28.00 mm, whereas in the group of fetuses in the third trimester of pregnancy, the range was 16.00-40.00 mm. In order to check the usefulness of this parameter, an analysis of this marker in fetuses with extracardiac anomalies, including genetic and non-genetic disorders is shown. The fetal ear measurement can fall within the normal range even if there are some genetic or non-genetic disorders. Therefore, the fetal ear measurement does not provide any diagnostic value in terms of detecting any fetal genetic and non-genetic disorders, which is supported by the analysis of the data provided in this study. Our study has proved that measurement of the fetal ear auricle is possible; however, its clinical usefulness for perinatal management is currently very limited.

Measures of Fetal Growth and Cardiac Structure in Stillbirths With Placental Maternal Vascular Malperfusion: Evidence for Heart Weight Sparing and Structural Cardiac Alterations in Humans.

Placental maternal vascular malperfusion (MVM) is associated with fetal growth restriction (FGR). While FGR increases the risk of cardiovascular disease, the impact of MVM on fetal cardiac structure is understudied. We utilized a cohort of autopsied stillbirths; 29 with MVM as the cause of death and 21 with a cause of death unrelated to MVM. Fetal and organ weights and heart measurements were standardized by gestational age and compared between MVM and non-MVM stillbirths. Differences in standardized fetal organ and cardiac measures as compared to standardized fetal body weight were calculated to account for body size. MVM stillbirths had smaller organ and heart weights than non-MVM stillbirths; however, after accounting for gestational age, heart weight was the least affected among all organs. In an analysis of organ weights relative to body size, heart weights were 0.31 standard deviations (SD) larger than expected relative to body weight (95% CI: 0.04, 0.57). Right and left ventricle thicknesses and mitral valve circumference were also larger than expected relative to body weight. Stillbirth due to MVM was associated with relative sparing of heart weight and other heart measurements. The significance of these findings in liveborn infants needs further study.

The effect of tauroursodeoxycholic Acid (TUDCA) treatment on placental endoplasmic reticulum (ER) stress in a rat model of advanced maternal age.

Advanced maternal age (≥35 years) is associated with an increased risk of pregnancy complications such as fetal growth restriction and preeclampsia. We previously demonstrated poor pregnancy outcomes (reduced fetal body weight), altered vascular function, and increased expression of endoplasmic reticulum (ER) stress markers (phospho-eIF2α and CHOP) in mesenteric arteries from a rat model of advanced maternal age. Further, treatment of aged dams during pregnancy with an ER stress inhibitor, tauroursodeoxycholic acid (TUDCA) increased fetal body weight (both male and female), tended to improve uterine artery function, and reduced expression of phospho-eIF2α and CHOP in systemic arteries. Placental ER stress has been linked to poor pregnancy outcomes in complicated pregnancies but whether placental ER stress is evident in advanced maternal age is not known. In addition, sex-specific changes in the placental labyrinth and junctional zones from male and female offspring in advanced maternal age have not been investigated. Therefore, the current study aimed to investigate the effect of TUDCA intervention on placental ER stress. We hypothesize that placental ER stress is increased in a rat model of advanced maternal age that is alleviated by TUDCA intervention for both sexes. Placental ER stress markers (GRP78, phospho-eIF2α, ATF-4, CHOP, ATF-6α, and sXBP-1) were quantified by Western blot in placentas from male and female offspring; the labyrinth and junction zones were analyzed separately. In the placental labyrinth zone from male offspring, only GRP78 (p = 0.007) was increased in aged dams compared to young dams; TUDCA treatment reduced the placental expression of GRP78 in aged dams (p = 0.003). In addition, TUDCA reduced the levels of phospho-eIF2α (p = 0.021), ATF-4 (p = 0.016), and CHOP (p = 0.012) in aged dams but no effect was observed in young TUDCA-treated dams. In the placental labyrinth zone from female offspring, an increased level of phospho-eIF2α (p = 0.005) was observed in aged dams compared to young dams, and TUDCA treatment had no effect in both young and aged groups. In the placental junctional zone from male and female offspring, no changes in the expression of GRP78, phospho-eIF2α, ATF-4, CHOP, and ATF-6α was observed with or without TUDCA treatment in both young and aged groups, however, a reduced expression of sXBP-1 protein was observed in from both male (p = 0.001) and female (p = 0.031) placentas from aged-TUDCA treated dams compared to aged control. In conclusion, our data highlight the complexity and sex-specificity of ER stress responses in advanced maternal age with TUDCA treatment maintaining ER stress proteins to basal levels and improving fetal growth in both male and female offspring.

Prenatal diagnosis of non-janiceps type of cephalopagus conjoined twins: a case report

BackgroundConjoined twin pregnancy is a very rare variety of twin pregnancy which results from the failure of complete separation of a zygote after 13 days, ‘cephalopagus’ being the rarest variety of such twin pregnancies. Two forms of cephalopagus conjoined twins have been described in the literature: Janiceps (two faces are on the either side of the head) and non-janiceps (with one head and a single face); non-janiceps type being even rarer. The features that may hint towards the diagnosis on ultrasound include inseparable fetal bodies, unvarying relative positioning of the two fetuses, both heads persistently at the same level to each other, bi-breech or bicephalic presentations and a single umbilical cord with more than three vessels. 3-D ultrasound and Fetal MRI may help in confirmation of this rare entity.Case presentationA 19-year-old primigravida, presented at 12 weeks of gestation for antenatal ultrasound. Ultrasonography showed evidence of a conjoined twin with a single head and single face, fused thoracic cavities with single heart, two lungs, fused upper abdomen with shared stomach and liver, separate pelvic cavities with two different urinary bladders and two pairs of upper and lower limbs. Fetal MRI corroborated these findings. The pregnancy was terminated vaginally, and cephalopagus fetus was delivered. The parents were appropriately counselled for future pregnancies.ConclusionsA very rare case of non-Janiceps variety of cephalopagus conjoined twin gestation which was detected at 12 weeks of gestation by antenatal ultrasound and confirmed on fetal MRI. Early antenatal diagnosis is extremely important for appropriate and timely management as the prognosis is very poor in such twins. Antenatal ultrasound and fetal MRI prove very beneficial in this aspect as well as for diagnosis of other associated fetal abnormalities.

Non immune hydrops fetalis due to Parvovirus B19 infection. A case report

Backround: The term “hydrops fetalis” refers to excessive accumulation of pathologic serous fluid within the fetal soft tissues and body cavities. There are two categories, the immune and the nonimmune hydrops (NIHF). Currently 90 percent of cases of hydrops are nonimmune, because of the decrease of incidence of immune with the advent of anti-D immune globulin. Case presentation: We present a case of Parvovirus B19 (PB19) infection that resulted in NIHF. Fetus had severe ascites, mild pericardial effusion and mild myocardial dilation, that appeared during the 30th gestational week. Fetal evaluation with sonography was repeated every week and the fetal growth curves, Dopplers and amniotic fluid index were normal. Each week there was a gradual recession of the effusions until the 36th gestational week, when they eventually resolved without any treatment. After delivery, the neonate was symptom – free. Conclusions: The cause of NIHF is identified in at least 60 percent prenatally and in more than 80 percent postnatally, while only 40 percent of pregnancies with NIHF result in a liveborn neonate. The prognosis is heavily dependent on etiology. Diaplacental transmission of PB19 on second trimester can cause fetal complications like hydrops, premature rapture of membranes, even fetal loss in about 30 percent. These cases should be closely followed in a Fetal Medicine Unit, especially if there is evidence of fetal anemia or hydrops.

Identification and Incidence of Spina Bifida during Gestation and its Pregnancy Outcomes

Aim: To identify the incidence of spina bifida during gestation and its pregnancy outcomes. Study design: Cohort study Place and duration of study: Department of Radiology, Chandka Medical College Hospital, Larkana from 1st October 2020 to 30th September 2022 Methodology: One thousand pregnant women who were screened for the identification of spina bifida. Doppler based ultrasonography was performed in each patient. The fetus body was examined during sonography Doppler between 18-24 weeks. The body of the fetus was focused and visualized longitudinally in midsagittal section. Spinal cord was traced from neck to sacral, cervical vertebra and thorax. A tram track appearance was observed. Spinal nerve positioning was also observed. In spina bifida nerve tethering was seen. The primary outcomes in reference to baby weight and maturity were recorded while secondary outcomes of the fetuses in terms of any disability were followed up to 12 months of age. Results: The mean age of the women was 25.6±5.6 years. The incidence of spina bifida was 1.1%. Within the primary outcomes observed birth weight ranged within 3.1-3.5kg. Around 81.81% cases were born full term while 18.18 were premature. On 06 months’ follow-up of the spina bifida cases it was observed that 45.45% of new born suffered from skin problems as sores, calluses or and blisters while 36.36% had hydrocephalus with excessive CSF which needed monitoring. Mobility issue and disability was observed in 27.27% cases. Conclusion: Spina bifida cases are identified successfully within gestational period. Prematurity can be significantly noticed in spina bifida cases. The lumbosacral and lumbar lesions are most common as well as skin conditions and hydrocephalus. Key words: Incidence, Spina bifida, Gestation, Outcome

Food taboo practices and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis

Food taboos have a negative impact on pregnant women and their fetuses by preventing them from consuming vital foods. Previous research found that pregnant women avoided certain foods during their pregnancy for a variety of reasons. This review aimed to determine the pooled prevalence of food taboo practices and associated factors in Ethiopia. In compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, we searched the literature using PubMed/MEDLINE, AJOL (African Journal Online), HINARI, Science Direct, Google Scholar, and Google electronic databases. The random-effects model was used to estimate the pooled prevalence of food taboo and its determinants at a 95% confidence interval with their respective odds ratios. The pooled food taboo practice among Ethiopian pregnant women was 34.22% (95% CI 25.47–42.96), and after adjustment for publication bias with the trim-and-fill analysis, the pooled food taboo practice of pregnant women was changed to 21.31% (95% CI: 10.85–31.67%). Having less than a secondary education level (OR = 3.57; 95% CI 1.43–8.89), having no ANC follow-up (OR = 4.35; 95% CI 1.12–16.94), and being a rural resident (OR = 3.08; 95% CI 1.14–8.28) were the significant factors. Dairy products, some fruits, green leafy vegetables, meat, and honey are among the taboo foods. The most frequently stated reasons for this taboo practice were: fear of producing a big fetus, which is difficult during delivery; attachment to the fetus's body or head; and fear of fetal abnormality.