Stages Of Gestation Research Articles

Exercise Effects on Maternal Vascular Health and Blood Pressure during Pregnancy and Postpartum: A Systematic Review and Meta-Analysis.

This systematic review aimed to assess the effects of exercise training during pregnancy and the postpartum period on maternal vascular health and blood pressure (BP). The outcome of interest were pulse wave velocity (PWV), flow-mediated dilation (FMD), and BP from pregnancy until 1-year postpartum. Five databases, including Ovid MEDLINE, EMBASE, CINAHL, Web of Science, and Cochrane Library, were systematically searched from inception to August 2023. Studies of randomized controlled trials (RCTs) comparing the effects of prenatal or postpartum exercise to a non-exercise control group were included. The risk of bias and the certainty of evidence were assessed. Random-effects meta-analyses and sensitivity analyses were conducted. In total, 20 RCTs involving 1,221 women were included. Exercise training, initiated from week 8 during gestation or between 6-14 weeks after delivery, with the program lasting for a minimum of 4 weeks up to 6 months, showed no significant impact on PWV and FMD. However, it resulted in a significant reduction in systolic BP (SBP) (MD: -4.37 mmHg; 95% CI: -7.48 to -1.26; p = 0.006) and diastolic BP (DBP) (MD: -2.94 mmHg; 95% CI: -5.17 to -0.71; p = 0.01) with very low certainty. Subgroup analyses revealed consistent trends across different gestational stages, types of exercise, weekly exercise times, and training periods. Exercise training during pregnancy and the postpartum period demonstrates a favorable effect on reducing maternal BP. However, further investigations with rigorous methodologies and larger sample sizes are needed to strengthen these conclusions.

A review of single-cell transcriptomics and epigenomics studies in maternal and child health.

Single-cell sequencing technologies enhance our understanding of cellular dynamics throughout pregnancy. We outlined the workflow of single-cell sequencing techniques and reviewed single-cell studies in maternal and child health. We conducted a literature review of single cell studies on maternal and child health using PubMed. We summarized the findings from 16 single-cell atlases of the human and mammalian placenta across gestational stages and 31 single-cell studies on maternal exposures and complications including infection, obesity, diet, gestational diabetes, pre-eclampsia, environmental exposure and preterm birth. Single-cell studies provides insights on novel cell types in placenta and cell type-specific marks associated with maternal exposures and complications.

104 Effects of providing vitamin and mineral supplementation throughout gestation on subsequent F1 replacement heifer liver and muscle oxygen consumption and mitochondrial function throughout pregnancy

Abstract The study aimed to assess the impact of maternal vitamin/mineral supplementation during gestation on the energy utilization in liver and muscle tissues of F1 heifer offspring. We hypothesized that VTM supplementation during gestation would mitigate mitochondrial energy loss and uncoupling of liver and muscle tissue in pregnant offspring. At breeding, crossbred Angus heifers [n = 31; initial body weight (BW) = 412.5 ± 53.68 kg] were randomly assigned to either a basal diet targeting BW gains of 0.45 kg•heifer-1•d-1(CON; n = 14) or the basal diet plus 113 g•heifer-1•d-1of a vitamin/mineral supplement (VTM; n = 17). Heifers remained on their respective dietary treatments until calving. After calving, all F1 heifer calves were raised in a single management group with their dams until weaning (BW = 209 ± 4.82 kg; VTM, n = 17; CON, n = 12) and fed a common diet throughout postnatal development. At breeding and throughout gestation, F1 heifers (n = 9, VTM; n = 7, CON) were allotted daily feed intakes of 1.5% of BW on a dry-matter basis as a total mixed ration and used to evaluate cellular energy metabolism throughout pregnancy. Liver and Longissimus dorsi muscle biopsies were collected on d 179 and d 247 +/- 3 of gestation and mitochondrial function was assessed via high resolution respirometry (Oroboros Instruments, Innsbruck, Austria). The following respiratory states were evaluated: LEAK respiration (L), OXPHOS capacity (P), NADH-linked OXPHOS (PI), and electron transfer capacity (E). Data were analyzed using the MIXED procedure of SAS with repeated measures where appropriate. No treatment × trimester interaction (P ≥ 0.13) was observed for any of the respiratory states in liver and muscle. Hepatic oxygen consumption was not influenced by maternal gestational VTM supplementation (P ≥ 0.68), or stage of gestation (P ≥ 0.27). In muscle, L respiration was the only state affected by maternal dietary treatments, being greater (P = 0.05) in CON than VTM heifers. Additionally, L respiration was greater (P = 0.02) during the third trimester compared with the second trimester. This observation in CON heifers is important because increased L respiration (proton leak) results in decreased ATP production. Protons that escape the intermembrane space, are dissipated as heat rather than be used for ATP synthesis; thus, oxygen consumption increases to compensate for the reduction of protons entering ATP turnover. Results show increased muscle mitochondria inefficiency in offspring with dams lacking supplementation during pregnancy. The increased incidence of proton leak results in potentially less efficient cattle as protons escape the electron transport chain rather than be transformed for energy utilization need of the animal, thus VTM supplementation throughout pregnancy impacts fetal development with potential effects in live offspring 18 to 22 mo post-parturition.

Decidual production of interferon lambda in response to ZIKV persistence: clinical evidence and in vitro modelling

Zika virus (ZIKV) infections during pregnancy can result in Congenital Zika Syndrome (CZS), a range of severe neurological outcomes in fetuses that primarily occur during early gestational stages possibly due to placental damage. Although some placentas can maintain ZIKV persistence for weeks or months after the initial infection and diagnosis, the impact of this viral persistence is still unknown. Here, we aimed to investigate the immunological repercussion of ZIKV persistence in term placentas. As such, term placentas from 64 pregnant women diagnosed with Zika in different gestational periods were analyzed by ZIKV RT-qPCR, examination of decidua and placental villous histopathology, and expression of inflammation-related genes and IFNL1-4. Subsequently, we explored primary cultures of term decidual Extravillous Trophoblasts (EVTs) and Term Chorionic Villi (TCV) explants, as in vitro models to access the immunological consequences of placental ZIKV infection. Placenta from CZS cases presented low IFNL1-4 expression, evidencing the critical protective role of theses cytokines in the clinical outcome. Term placentas cleared for ZIKV showed increased levels of IFNL1, 3, and 4, whether viral persistence was related with a proinflammatory profile. Conversely, upon ZIKV persistence placentas with decidual inflammation showed high IFNL1-4 levels. In vitro experiments showed that term EVTs are more permissive, and secreted higher levels of IFN-α2 and IFN-λ1 compared to TCV explants. The results suggest that, upon ZIKV persistence, the maternal-skewed decidua contributes to placental inflammatory and antiviral signature, through chronic deciduitis and IFNL upregulation. Although further studies are needed to elucidate the mechanisms underlying the decidual responses against ZIKV. Hence, this study presents unique insights and valuable in vitro models for evaluating the immunological landscape of placentas upon ZIKV persistence.

Supplementation of critical micro-nutrients in peri‑parturient dairy buffaloes improves lactation performance

BackgroundThe peri‑parturient period is the most vital period of a dairy animal's life and affects its future performance. Dairy animals get exposed to severe metabolic stress during the peri‑parturient period and their stress tolerance capacity during the period remains a key factor to harvest optimum production from these animals without getting exposed to any of peri‑parturient disorders. The study aimed to evaluate the effect of weekly critical micro-nutrient (CMN) supplementation during the periparturient period on the lactation performance of Murrah buffaloes. MethodsWeekly CMN (vitamins E, A, and niacin with minerals Co, Cr, Cu, Se, and Zn) supplementation during the periparturient period (56 days prepartum, till 56 days post-partum) was performed on twenty-two healthy Murrah buffaloes during their advanced stage of gestation following dividing them into two groups of 11 buffaloes in each group, representing control and supplemented (Treatment) groups. Buffaloes were selected and sustained on recommended practices of feeding as per nutrient requirements, except the inclusion of CMN supplement once a week in the treatment group's buffaloes after proper mixing with common concentrate mixture being fed to buffaloes. Weekly milk production recording was carried out with analysis of milk quality parameters, for an initial 10 weeks of the lactation. ResultsThe treatment helped in improving the milk production record of buffaloes; total milk yield by 18 % and fat-corrected milk by 30 % (P < 0.05). It leads to qualitative improvement as well (percentage of milk fat and protein, P < 0.05). ConclusionIt may be concluded that weekly supplementation of critical micronutrients during the periparturient period helps improve buffalo milk production performance.

Human CD56+CD39+ dNK cells support fetal survival through controlling trophoblastic cell fate: immune mechanisms of recurrent early pregnancy loss

Abstract Decidual natural killer (dNK) cells are the most abundant immune cells at early stage of pregnancy in rodents and humans, and emerging single-cell transcriptomic studies have uncovered various human dNK subsets that are disrupted in patients experiencing recurrent early pregnancy loss (RPL) at early gestational stage, suggesting a connection between abnormal proportions or characteristics of dNK subsets and RPL pathogenesis. However, the functional mechanisms underlying this association remain unclear. Here, we established a mouse model by adoptively transferring human dNK cells into pregnant NOG (NOD/Shi-scid/IL-2Rγnull) mice, where human dNK cells predominantly homed into the uteri of recipients. Using this model, we observed a strong correlation between the properties of human dNK cell and the outcomes of pregnancy. The transfer of dNK cells from RPL patients (dNK-RPL) remarkably worsened early pregnancy loss and impaired placental trophoblast cell differentiation in the recipients. These adverse effects were effectively reversed by transferring CD56+CD39+dNK cells. Mechanical studies revealed that CD56+CD39+ dNK subset facilitate early differentiation of mouse trophoblast stem cells (mTSCs) towards both invasive and syncytial pathways through secreting macrophage colony-stimulating factor (M-CSF). Administration of recombinant M-CSF to NOG mice transferred with dNK-RPL efficiently rescued the exacerbated pregnancy outcomes and fetal/placental development. Collectively, this study established a novel humanized mouse model featuring functional human dNK cells homing into the uteri of recipients and uncovered the pivotal role of M-CSF in fetal-supporting function of CD56+CD39+ dNK cells during early pregnancy, highlighting that M-CSF may be a previously unappreciated therapeutic target for intervening RPL.

Lipidomics and plasma hormone analysis differentiate reproductive and pregnancy statuses in Florida manatees (Trichechus manatus latirostris)

Florida manatees (Trichechus manatus latirostris) are protected as a threatened species, and data are lacking regarding their reproductive physiology. This study aimed to (1) quantify plasma steroid hormones in Florida manatees from two field sites, Crystal River and Indian River Lagoon, at different gestational stages and to (2) identify individual lipids associated with pregnancy status. Ultra-high performance liquid chromatography-tandem mass spectrometric analysis was used to measure plasma steroid hormones and lipids. Pregnant female manatees were morphometrically distinct from male and non-pregnant female manatees, characterized by larger body weight and maximal girth. Progesterone concentrations in manatees were also elevated during early gestation versus late gestation. Cholesterol, an important metabolic lipid, and precursor for reproductive steroids, was not different between groups. Mass spectrometry quantified 949 lipids. Plasma concentrations of glycerophospholipids, glycerolipids, sphingolipids, acylcarnitines, and cholesteryl esters were associated with pregnancy status in the Florida manatee. Most of the lipid species associated with pregnancy were triacylglycerides, phosphatidylethanolamines, and ether-linked phosphatidylethanolamines, which may serve as energy sources for fetal development. This research contributes to improving knowledge of manatee reproductive physiology by providing data on plasma steroid hormones relative to reproductive status and by identifying plasma lipids that may be important for pregnancy. Elucidation of lipid species directly associated with pregnancy has the potential to serve as a diagnostic approach to identify pregnant individuals in fresh and archived samples. These biochemical and morphometric indicators of reproductive status advance the understanding of manatee physiology.

Use of a precision feeding program during gestation improves the performance of high-producing sows

Current gestating sow feeding strategies are based on using a single diet regardless of parity or gestation stage. Precision feeding (PF) of the individual sows allows dynamic changes in amino acid and energy requirements throughout gestation. The hypothesis of the study was that meeting the daily predicted amino acid and energy demands of gestating sows using a mathematical model and automatic precision feeder to establish the nutrition programs, would improve reproductive and productive performance compared to conventional feeding programs. Seventy-five mixed-parity sows were distributed among 3 treatments. A treatment managed as flat curve (FLAT: 2.1kg/d, 1 – 110 d), a high-low-high curve (HLH: 2.2kg/d, 1 – 49 d; 2.0kg/d, 50 – 84 d; 2.6kg/d, 85 – 110 d), where sows received the same diet with 3.2 Mcal/kg of metabolizable energy (ME) and 0.7g/kg of standardized ileal digestible (SID) lysine. For the PF treatment, feeding level and blend of 2 basal diets (3.0 Mcal/kg of ME; 8.0 and 2.0g/kg of SID lysine for high and low lysine, respectively) was adjusted daily for each sow to accurately meet estimated amino acid and energy requirements based on live weight, gestation stage and parity. Sows fed PF were heavier on d 110 of gestation (P = 0.011) and tended to increase total number of born (P = 0.092) and born alive (P = 0.077). Sows fed PF showed a higher litter weight (P = 0.003) at birth, lower lactation feed intake (P = 0.010), higher milk yield (P = 0.043) and a larger litter size (P = 0.050). Precision feeding sows also presented an improved maternal transformation index (P = 0.013) when compared to HLH and FLAT. In conclusion, our results demonstrate that the application of PF strategies based on daily nutrient adjustments is highly beneficial for high-producing sows to support the dynamic needs for nutrient availability for the sow´s body growth, mammary gland and fetal development.

416 MRI Findings in Preterm Infants Associated with Strabismus

OBJECTIVES/GOALS: Prematurity and perinatal brain injury are known risk factors for strabismus. In this study, we sought to understand the link between neonatal neuroimaging measures in very preterm infants and the emergence of strabismus later in life. Study findings may inform if neonatal brain MRI could serve as a prognostic tool for this visual disorder. METHODS/STUDY POPULATION: This study draws from a longitudinal cohort of very preterm infants (VPT, &lt; 30 weeks gestation, range 23 – 29 weeks) who underwent an MRI scan at 36 to 43 weeks postmenstrual age (PMA). Anatomic and diffusion MRI data were collected for each child . A subset of thirty-three patients in this cohort had records of an eye exam, which were reviewed for a history of strabismus. Patients with MRI scans demonstrating cystic periventricular leukomalacia or grade III/IV intraventricular hemorrhage were classified as having brain injury. Clinical variables with a known association to strabismus or diffusion metrics were included in a multivariable logistic regression model. Diffusion tractography metrics were screened for association with strabismus on univariable analysis prior to inclusion in the regression model. RESULTS/ANTICIPATED RESULTS: A total of 17/33 (51.5%) patients developed strabismus. A logistic regression model including gestational age, PMA at MRI, retinopathy of prematurity (ROP) stage, brain injury, and fractional anisotropy of the right optic radiation was significant at the .001 level according to the chi-square statistic. The model predicted 88% of responses correctly. Each decrease of 0.01 in the fractional anisotropy of the right optic radiation increased the odds of strabismus by a factor of 1.5 (95% CI 1.03 – 2.06; p = .03). Patients with brain injury had 15.8 times higher odds of strabismus (95% CI 1.1 – 216.5; p = .04). Gestational age (OR 1.7; 95% CI 0.9 – 3.3; p = .1) and stage of ROP (OR 0.6; 95% CI 0.2 – 2.0; p = .4) were not significant predictors of strabismus in the multivariable model. DISCUSSION/SIGNIFICANCE: Our findings suggest that strabismus in VPT patients may be related to specific changes in brain structure in the neonatal period. The identified association between neonatal optic radiation microstructure and strabismus supports the possibility of using brain MRI in very preterm infants to prognosticate visual and ocular morbidity.

The Teratogenic Effect of Dimefluthrin-Based Mosquito Coils on Pregnant Mice (Mus musculus L.)

Dimefluthrin, a synthetic pyrethroid insecticide, claims to be safe and harmless to mammals. However, the potential risk of mosquito coils containing dimefluthrin to pregnant mice remains uncertain. This study aimed to examine the teratogenic effect of dimefluthrin when inhaled by pregnant mice at different stages of gestation. The study used mosquito coils with 0.031% dimefluthrin as the active ingredient and was exposed to pregnant mice at various pregnancy stages. The results revealed that mosquito coils with dimefluthrin had teratogenic effects, reducing the number of live fetuses and increasing the number of dead fetuses, especially from the seventh to the eighteenth day of pregnancy. Additionally, there was a decrease in fetal weight, length, and volume, particularly during the seventh to eighth day of gestation. Hemorrhages were observed as fetal abnormalities and were highest three hr after exposure every day during pregnancy. The conclusion of this research is pregnant mice exposed to mosquito coil smoke containing dimefluthrin experienced a decrease in the number of live fetuses and an increase in fetal mortality. While there was no significant impact on reabsorption, the fetuses showed reduced weight, and size, and an increased incidence of hemorrhages when exposed for three hr daily during pregnancy.

Temporal metabolomics state in pregnant rat: Analysis of amniotic fluid, placenta, and maternal plasma at embryonic and fetal time points

IntroductionDuring pregnancy, the dynamic metabolic demands for fetal growth require a continuous supply of essential metabolites. Understanding maternal metabolome changes during gestation is crucial for predicting disease risks in neonates. MethodsThe study aimed to characterize the placental and amniotic fluid (AF) metabolomes during gestation in rats at gestational days GD-13 and 19 reflecting the end of the embryonic and fetal periods, respectively, and the maternal plasma, using metabolomics (LC-MS) and chemometrics. The objective was to highlight, through univariate and multivariate analyses, the complementarity of the data obtained from these different biological matrices. ResultsThe biological matrix had more impact on the metabolome composition than the gestational stage. The placental and AF metabolomes showed specific metabolome evolving over the two gestational stages. Analyzing the three targeted metabolomes revealed evolving pathways in arginine and proline metabolism/glutathione metabolism and phenylalanine metabolism; purine metabolism; and carbohydrate metabolism. Significantly, lipid metabolism in the placenta exhibited substantial changes with higher levels of certain phosphatidylethanolamine and sphingomyelins at GD19 while some cholesteryl esters and some glycosphingolipids levels being in higher levels at GD13. DiscussionThese data highlight the metabolic gradients (mainly in placenta, also in AF, but only a few in plasma) observed through embryonic patterning and organ development during mid-to late gestation.

Morphomatrical Study of the Ovary of Local Goats (Capra hircus) During Different Stages of Pregnancy

Understanding the morphometric differences in goat ovaries between pregnant and non-pregnant individuals can contribute to improving reproductive management and assist in interpreting ovarian-related abnormalities. It may also provide valuable insights into the dynamic changes occurring in the ovary of local goats (Capra hircus) during pregnancy. This study aimed to investigate and compare the morphometric features of ovaries in pregnant and non-pregnant goats. Sixteen healthy female domestic goats (Capra hircus) were selected to collect organs. The female goats were categorized into two groups: mature, non-pregnant goats (n = 4) and pregnant goats with a single pregnancy (n = 12). The study found no significant difference in the length of ovaries between non-pregnant and pregnant goats but significant increases in width, thickness, and weight at different gestation stages. The right ovary had more significant weight and dimension in both groups. Additionally, the presence of [CL] during pregnancy, these changes can affect the size, dimensions, and weight of the ovaries  

Features of the state of extraembryonic structures in miscarriage early terms of pregnancy

Background. Despite the modern achievements of medicine, miscarriage remains the main problem of obstetrics and gynecology science and practice. Purpose – to assess the features of the state of extraembryonic structures in case of miscarriage in the early stages of gestation. Materials and Methods. Under observation were 32 patients (main group) with a verified threat of pregnancy termination with bleeding in the embryonic period of gestation (up to 10 weeks) and 20 women (control group) with a physiological course of early pregnancy. The exclusion criteria from the study were patients with induced pregnancy, multiple pregnancies, anomalies of the development of female genital organs. All patients underwent a standard clinical and laboratory examination. During the ultrasound examination, both the state of the embryo and the state of extraembryonic structures were evaluated: the volume of the fertilized egg (V f/e), the average internal diameter of the yolk sac, the nature of vascularization of the corpus luteum, the state of hemodynamics in the myometrium. During transvaginal ultrasound, the chorionic volume (Vc) was calculated and its vascularization index (VI) was evaluated using a special three-dimensional VOCAL program. Results. Analysis of embryo biometrics in the studied groups did not reveal any significant difference. When assessing the state of extra-embryonic structures, we found that the volume of the fertilized egg and the average internal diameter of the yolk sac in women with miscarriage in the embryonic period of gestation was significantly lower. The volume of the corpus luteum of the ovary in the main group was equal to 3.0±0.3 cm3 in the control group – 5.3±0.61 cm3 , (p &lt; 0.05). Vascularization of the corpus luteum in patients with bleeding in early pregnancy was also reduced. In patients with threatened termination of pregnancy with bleeding, Vc was 32.5±2.08 cm3 in control 71.6±2.4 cm3 . The vascularization index of the chorion in pregnant women of the main group was equal to 9.5±1.2, while in women with a physiological course of gestation it was 19.1±1.7 (p&lt;0.05). When evaluating the hemodynamics in the myometrium, it was also established that the resistance index in the uterine and spiral arteries in the patients of the main group was significantly higher compared to the pregnant women of the control group. Conclusions. When there is a threat of pregnancy termination with bleeding in the embryonic period of intrauterine development of the child, significant changes occur in extraembryonic structures. A decrease in the volume of the fertilized egg, the average internal diameter of the yolk sac, blood flow disorders in the corpus luteum and myometrium, a decrease in vascularization of the chorion and its hypoplasia create a high risk of developing placental dysfunction and worsen the prognosis of pregnancy.

Differential Development of the Chordae Tendineae and Anterior Leaflet of the Bovine Mitral Valve.

There is increasing evidence that some adult mitral valve pathologies may have developmental origins involving errors in cell signaling and protein deposition during valvulogenesis. While early and late gestational stages are well-documented in zebrafish, chicks, and small mammalian models, longitudinal studies in large mammals with a similar gestational period to humans are lacking. Further, the mechanism of chordae tendineae formation and multiplication remains unclear. The current study presents a comprehensive examination of mitral anterior leaflet and chordae tendineae development in a bovine model (a large mammal with the same gestational period as humans). Remarkably distinct from small mammals, bovine development displayed early branched chordae, with increasing attachments only until birth, while the anterior leaflet grew both during gestation and postnatally. Chordae also exhibited accelerated collagen deposition, maturation, and crimp development during gestation. These findings suggest that the bovine anterior leaflet and chordae tendineae possess unique processes of development despite being a continuous collagenous structure and could provide greater insight into human valve development.

Molecular detection of Ovine listeric abortion in Nineveh governorate, Iraq

Listeriosis is a important abortive diseases in sheep , and is considered one of the most risky bacterial zoonotic disease worldwide.The study was carried out in 50 sheep flocks placed in the Nineveh governorate, Iraq during November and December 2022, a total of 300 specimens of blood , abomasum content and brain ( 100 each)were collected from local breed ovine aborted fetues(in the last stage of gestation) were obtained to be tested for molecular detection of Listeria monocytogenes . L monocytogenes DNA was detected in a total of 61(20.3%) specimens , distributed as: 35(57.4%) ,15(24.6% and 11(18.0%) strains from fetal brain, abomasum and blood specimens respectively using direct genus-specific conventional polymerase chain reaction (prfA gene) C- PCR. Two L. monocytogenes strains ( HMB1 listeriolysin, HMB 2 listeriolysin ) deposited in GenBank under accession numbers LC769365.1,and LC769366.1. All L. monocytogenes strains were positive for three genes (InlJ, InlA, and hlyA) except actA gene was detected in 46 (75.4%) strains. In conclusion , L. monocytogenes is one of the important causal agents of abortion in sheep flocks in Nineveh province , Iraq, and most of the brain specimens were positive for listeric infection compared to the other specimens.

Assessment of the impact of COVID-19 experienced at different stages of gestation on perinatal outcomes and structural changes in the placenta

BACKGROUND: At the beginning of the pandemic COVID-19, the attention of obstetricians and gynecologists was focused on studying the impact of SARS-CoV-2 on obstetric and perinatal outcomes. Currently, the dynamics of mutations in genes encoding SARS-CoV-2 proteins determines the emergence of a large number of new strains of the virus that are highly virulent. Given this fact, the problem of assessing the impact of COVID-19 on pregnancy outcomes also remains relevant.&#x0D; AIM: The aim of this study was to assess the impact of the novel coronavirus infection (COVID-19) transmitted at different stages of gestation on perinatal outcomes and structural changes in the placenta.&#x0D; MATERIALS AND METHODS: In 2022–2023, a prospective analysis of 113 cases of childbirth in women who had the novel coronavirus infection during pregnancy was carried out in obstetric institutions in Novosibirsk. The total sample of subjects was divided into three study groups using cluster analysis. Group 1 included 25 women who had SARS-CoV-2 at a gestation period of up to 16 weeks; Group 2 consisted of 61 patients who underwent COVID-19 at gestation period of 17 to 34 weeks; and Group 3 comprised 27 pregnant women in whom COVID-19 was detected after 34 weeks of pregnancy. The control group included 65 pregnant women who had a negative smear test result for SARS-CoV-2. Pathological examination of the placenta included macro- and microscopic studies. Statistical processing of the results was carried out using the IBM SPSS Statistics Version 25.0 program.&#x0D; RESULTS: The most common fetal distress was observed in patients of Groups 1 and 2 (p = 0.002). We found an inverse correlation between the gestational age at which a woman suffered coronavirus infection and the volumetric density of capillaries and intervillous fibrinoid, as well as the percentage of formation of the syncytial-capillary membrane and villi with symplastic buds. On the contrary, a direct correlation between the gestational age and the volumetric density of connective tissue was found. Intervillusitis was more often observed in the placentas of women of Groups 1 and 2. Histitocytic infiltration was characteristic of the placentas of patients of Group 2.&#x0D; CONCLUSIONS: The frequency of adverse perinatal outcomes and the intensity of structural changes in the placenta depend on the gestation period in which the patient suffered the novel coronavirus infection. The most significant structural changes in the placenta were detected in patients of Group 2.

Noninvasive Tracking of Embryonic Cardiac Dynamics and Development with Volumetric Optoacoustic Spectroscopy.

Noninvasive monitoring of cardiac development can potentially prevent cardiac anomalies in adulthood. Mouse models provide unique opportunities to study cardiac development and disease in mammals. However, high-resolution noninvasive functional analyses of murine embryonic cardiac models are challenging because of the small size and fast volumetric motion of the embryonic heart, which is deeply embedded inside the uterus. In this study, a real time volumetric optoacoustic spectroscopy (VOS) platform for whole-heart visualization with high spatial (100µm) and temporal (10ms) resolutions is developed. Embryonic heart development on gestational days (GDs) 14.5-17.5 and quantify cardiac dynamics using time-lapse-4D image data of the heart is followed. Additionally, spectroscopic recordings enable the quantification of the blood oxygenation status in heart chambers in a label-free and noninvasive manner. This technology introduces new possibilities for high-resolution quantification of embryonic heart function at different gestational stages in mammalian models, offering an invaluable noninvasive method for developmental biology.

Prevalence, Pattern and Outcome of Congenital Anomalies in Patients Admitted at a Tertiary Level Hospital in Bangladesh

Congenital anomalies are a major public health concern globally, contributing significantly to perinatal and neonatal mortality. Understanding their prevalence, patterns, and outcomes are essential for effective healthcare planning and interventions. This cross-sectional observational study aimed to investigate the distribution and immediate outcomes of congenital anomalies among infants delivered at Bangabandhu Sheikh Mujib Medical College Hospital, Faridpur, Bangladesh. Study population comprised admitted pregnant mothers who delivered infants with congenital anomalies from January to December 2022. Data were collected from medical records, including parity, gestational age at delivery, mode of delivery and outcomes of congenital anomalies. Total 3461 deliveries occurred during this period, of which 88 had congenital anomalies with a prevalence of 2.54%. Among the 88 infants with congenital anomalies, the most prevalent anomalies were Anencephaly and Hydrocephalus, affecting the central nervous system. Anencephaly had a 100% mortality rate, emphasizing its severity and poor prognosis. Anencephaly was more common in infants delivered between 12 to 28 weeks. Early gestational stages play critical role in its pathogenesis. Hydrocephalus showed a relatively higher proportion of live births. Vaginal delivery was the predominant mode of delivery for most congenital anomalies. Public health efforts targeting early detection, appropriate care and support for affected families can potentially reduce the impact of congenital anomalies on maternal and neonatal health. Bangabandhu Sheikh Mujib Med. Coll. J. 2024;3(1):27-31

Serum Ferritin Level and Total Iron Binding Capacity Relationship with Iron Deficiency Anemia During Pregnancy and Labour

Background: Iron deficiency anemia (IDA) is a prevalent condition globally, impacting maternal and fetal health outcomes significantly. The condition is especially concerning during pregnancy, given its association with complications such as preterm labor and increased maternal and neonatal morbidity and mortality rates. Objective: The study aimed to assess the prevalence of IDA among pregnant women and its correlation with fetal-maternal complications, as well as to evaluate the effectiveness of current healthcare interventions in managing the condition. Methods: A cross-sectional study was conducted at Shikhzayad Women Hospital, Larkana, over six months from January 1, 2022, to July 1, 2022. Fifty pregnant women with IDA at various gestational stages were selected and evaluated for serum ferritin and total iron-binding capacity (TIBC). The severity of anemia and its correlation with feto-maternal complications were analyzed using SPSS version 25. Results: Out of the 50 women studied, 6 had mild anemia, 37 had moderate anemia, and 7 had severe anemia. Serum ferritin levels showed that 10 participants had levels between 5-10 mg/L, 20 had levels between 10-50 mg/L, 10 had levels between 50-150 mg/L, and 10 had normal levels (150-300 mg/L). Elevated TIBC levels (400-600 ug/ml) were observed in 30 women. Feto-maternal complications included emergency cesarean sections (28 cases), postpartum hemorrhage (8 cases), disseminated intravascular coagulation (6 cases), cardiac failure (4 cases), and maternal death (4 cases). Pregnancy outcomes were reported as 5 first-trimester abortions, 2 second-trimester abortions, 4 preterm deliveries, 15 cases of intrauterine growth restriction (IUGR), 9 intrauterine deaths (IUD), and 5 neonatal deaths (NND). Conclusion: IDA remains a significant determinant of adverse maternal and neonatal outcomes. This study underscores the urgent need for enhanced preventive strategies, including iron supplementation and dietary education. Further large-scale research is required for a comprehensive understanding of IDA's impact and the development of targeted interventions.

A longitudinal and cross-sectional study of placental circulation between normal and placental insufficiency pregnancies

IntroductionTo longitudinally and cross-sectionally study the differences in the uterine artery pulsatility index (UTPI), umbilical artery pulsatility index (UAPI) and placental vascularization indices (PVIs, derived from 3-dimensional power Doppler) between normal and placental insufficiency pregnancies throughout gestation. MethodsUTPI, UAPI and PVI were measured 6 times at 4- to 5- week intervals from 11 to 13+6 weeks–36 weeks. Preeclampsia (PE) and fetal growth restriction (FGR) were defined as placental insufficiency. Comparisons of UTPI, UAPI and PVI between normal and insufficiency groups were performed by one-way repeated measures analysis of variance. ResultsA total of 125 women were included: monitored regularly from the first trimester to 36 weeks of gestation: 109 with normal pregnancies and 16 with placental insufficiency. Longitudinal study of the normal pregnancy group showed that UTPI and UAPI decreased significantly every 4 weeks, while PVIs increased significantly every 8 weeks until term. In the placental insufficiency group however, this decrease occurred slower at 8 weeks intervals and UTPI stabilized after 24 weeks. No significant difference was noted in PVIs throughout pregnancy. Cross-sectional study from different stages of gestation showed that UTPI was higher in the insufficiency group from 15 weeks onward and PVIs were lower after 32 weeks. DiscussionCompared to high-risk pregnancies with normal outcome, UTPI and UAPI needed a longer time to reach a significant change in those with clinical confirmation of placental insufficiency pregnancies and no significant change was found in PVI throughout gestation. UTPI was the earliest factor in detecting adverse outcome pregnancies.