Partum Research Articles

Health-related quality of life in children and adolescents born very preterm and its correlates: a cross-sectional study

ObjectiveWe aimed to assess health-related quality of life (HRQOL) in a cohort of very preterm born children and adolescents (aged 5–16), and to compare it with their fullterm born siblings...

No birth-associated maternal mortality in Japanese macaques (Macaca fuscata) despite giving birth to large-headed neonates

Human fetuses at term are large relative to the dimensions of the maternal birth canal, implying that their birth can be associated with difficulties. The tight passage through the human birth canal can lead to devastating outcomes if birth becomes obstructed, including maternal and fetal death. Although macaques have to accommodate similarly large fetuses, relative to their maternal birth canals, it was not known whether macaque mothers face birth difficulties similar to humans. Based on 27 y of demographic data from a semi-free-ranging, closely monitored population of Japanese macaques (Macaca fuscata), we found no birth-associated mortality in macaques. This differs from the situation in many human populations. We suggest three nonmutually exclusive hypotheses to explain these observations. i) The macaque fetal skull is similarly flexible as the human fetal skull. ii) The macaque pelvis and connective tissue show greater flexibility during birth. iii) The interplay between macaque pelvic shape and birth dynamics is smoother and incurs fewer complications than in humans.

Laughing like a caveman: excess and experience inside Georges Bataille’s Lascaux

ABSTRACT Towards the end of his life, Bataille became increasingly fascinated by prehistoric culture. His analysis of the Lascaux cave frames it as the symbolic site of our birth, envisioning in its art the final step to anthropogenesis: we, as a species, became human once we began smearing pigment on cave walls. Bataille’s account of this dual birth of art and humanity is neither an ode to our rational mind nor to our capacity for aesthetic contemplation. Rather, the murals adorning the cave would be the result of primordial ecstatic experiences. For Bataille, art ties in with excess: an activity devoid of use-value rising above necessity or instinct. Lascaux becomes the scene of a primordial crime against utility. Bataille’s cave stands as a counterargument to the enlightenment’s fixation on progress and productivity. The decades since, have seen our obsession with productivity grow even more pervasive. This paper explores the constellation of excessive behaviours which Bataille presents as key to the birth of art and, through an autoethnographic study, asks whether, and how, this ‘spectrum of excess’ is still relevant to artists today.

Investigating the Relationship between the General Health of Mothers and their Maternal Performance following Vaginal Childbirth

Background Birthing parents need to use specialized skills as the first caregivers of the newborn. Several factors may affect maternal performance, the general health of the birthing parent (e.g., mother) being one of them. Yet, there is a paucity of research in this area, particularly in Iran, and evidence remains inconsistent. Consequently, this study aimed to determine any correlations between maternal performance and the general health of mothers following vaginal childbirth in the context of Iran. Methods This cross-sectional study was conducted with people identifying as mothers (n = 450) who had given birth (< two months) and been referred for the vaccination of their newborn. The multi-stage sampling method was carried out from April 2022 to February 2023. Participants who met the inclusion criteria completed a demographic and obstetric information questionnaire, along with the Barkin maternal performance and general health questionnaire. To investigate the relationship between maternal performance and the general health of the mothers, an independent t-test analysis was conducted . The level of statistical significance was set at p < 0.05. Results The mean age of participants was 26.78, and the mean total score of maternal performance was 91.04 (0 - 120). The highest and lowest scores related to the ‘maternal competence’ and the ‘maternal needs’ domains, respectively. Overall, 76.89% of participants had a favorable general health condition (a score of less than 3.5 is considered favorable). There was no statistically significant difference identified in terms of maternal performance scores between those with a favorable and those with an unfavorable general health status. Conclusion Although the results of the present study did not show a significant relationship between the general health of mothers and maternal performance, this research builds on a growing body of evidence in the context of Iran. Despite recording high maternal performance scores in this sample, it will be important to enhance and maintain good mental health in all childbearing people, particularly following vaginal childbirth, as it is this which will enhance care and outcomes overall.

Human birth tissue products as a non-opioid medicine to inhibit post-surgical pain.

Pain after surgery causes significant suffering. Opioid analgesics cause severe side effects and accidental death. Therefore, there is an urgent need to develop non-opioid therapies for managing post-surgical pain. Local application of Clarix Flo (FLO), a human amniotic membrane (AM) product, attenuated established post-surgical pain hypersensitivity without exhibiting known side effects of opioid use in mice. This effect was achieved through direct inhibition of nociceptive dorsal root ganglion (DRG) neurons via CD44-dependent pathways. We further purified the major matrix component, the heavy chain-hyaluronic acid/pentraxin 3 (HC-HA/PTX3) from human AM that has greater purity and water solubility than FLO. HC-HA/PTX3 replicated FLO-induced neuronal and pain inhibition. Mechanistically, HC-HA/PTX3 induced cytoskeleton rearrangements to inhibit sodium current and high-voltage activated calcium current on nociceptive neurons, suggesting it is a key bioactive component mediating pain relief. Collectively, our findings highlight the potential of naturally derived biologics from human birth tissues as an effective non-opioid treatment for post-surgical pain. Moreover, we unravel the underlying mechanisms of pain inhibition induced by FLO and HC-HA/PTX3.

Evaluating the effectiveness and adverse effects of oral versus transdermal estradiol for endometrial preparation in frozen-thawed embryo transfer: a randomized controlled trial

BackgroundEndometrial preparation significantly influences the success of embryo transfer procedures. Although both oral and transdermal estradiol are common methods for endometrial priming, their efficacy and potential side effects remain uncertain. This randomized controlled trial aims to compare the effectiveness of oral and transdermal estradiol in endometrial preparation, while also evaluating their respective side effects in patients undergoing assisted reproduction treatments.MethodThis randomized clinical trial (ISRCTN15301227) was conducted at Hung Vuong Hospital between July 2020 and March 2022. Among 550 eligible patients undergoing frozen embryo transfer cycles, we included 380 patients for the study. The study protocol and all materials received approval from the Ethics Committee of Hung Vuong Hospital (1315/CN-HĐĐĐ). Participants were randomly assigned to one of two groups: Group A (n =190) received oral estradiol at an initial dose of 4 mg per day for 7 days, with the dose increased according to clinical response. Group B (n =190) received transdermal estradiol at an initial dose of 2 measures of 2.5 g estradiol gel per day for 7 days, with the dose similarly increased according to clinical response. Treatment in both groups began on days 2–3 of the menstrual cycle, with the maximum duration of estradiol administration being 27 days. We compared estradiol levels on the day of progesterone administration, duration of treatment, total estradiol dose, endometrial thickness, pregnancy outcomes, and any observed side effects between the two groups.ResultsGroup A exhibited significantly higher estradiol levels on the day of progesterone administration compared to Group B (270.5 pg/ml versus 186.5 pg/ml, p < 0.001). However, the comparison revealed no significant difference in endometrial thickness between the two groups (10.5 mm versus 10.6 mm, p = 0.85). Furthermore, pregnancy rates including positive human chorionic gonadotropin, clinical pregnancy, ongoing pregnancy, live birth, and pregnancy failure were also found to be similar between the two groups. Notably, a greater proportion of patients in Group A experienced mild side effects compared to those in Group B (20.3% versus 10.1%, respectively; n =37 versus n =18), and this discrepancy was found to be statistically significant (p = 0.007).ConclusionTransdermal estradiol offers comparable endometrial thickness and pregnancy outcomes, along with improved patient compliance and fewer side effects compared to oral estradiol.

Development of a dictionary of information items inspired by common data models to support health research data access requests

A network of organizations collaborates to provide services to facilitate multi-regional research across Canada. To streamline the data access process, the network is developing a dictionary of information items (InfoItems), providing a label and definition that represent a semantic sourced from an ontology (e.g., “human birth date” from a demography ontology). This allows for a standardized and shareable means to express data requirements. Inspired by health-research common data models (CDMs) like those from the Observational Medical Outcomes Partnership (OMOP) and the Canadian Network for Observational Drug Effects (CNODES), approximately 60 InfoItems were developed by the network. As a pilot exercise, four data centres mapped their data assets to the InfoItems to ensure they are relevant to the Canadian health data context. This has laid the foundation for InfoItems as a basic data harmonization mechanism. The new InfoItems-based data dictionary promotes the standardization of data asset contents across the network’s data centres. Researchers can use the dictionary to specify a project’s data requirements, establishing details like data availability across multiple regions, for inclusion in their data access request. The InfoItems dictionary is pivotal in simplifying data access requests, promoting multi-regional research in Canada. This resource can simultaneously safeguard the quality of analytical results and optimize data extraction into existing data models (e.g., health-research CDMs). Ongoing improvements in this area aim to enhance user experience and facilitate quality research.

Examination of piperonyl butoxide developmental toxicity as a Sonic hedgehog pathway inhibitor targeting limb and palate morphogenesis

Piperonyl butoxide (PBO) is a pesticide synergist with widespread use and human exposure that was discovered to inhibit Sonic hedgehog (Shh) signaling, a pathway required for numerous developmental processes. Previous examinations of PBO’s potential for developmental toxicity have generated seemingly conflicting results. We investigated the impact of acute PBO exposure targeting Shh pathway activity during palate and limb morphogenesis. Timed-pregnant C57BL/6 J mice were exposed to a single PBO dose (67–1800 mg/kg) at gestational day (GD) 9.75, and litters were collected at GD10.25 and GD10.75 to examine Shh pathway activity or GD17 for phenotypic assessment. PBO exposure induced dose-dependent limb malformations and cleft palate in the highest dose group. Following PBO exposure, reduced expression of the Shh pathway activity markers Gli1 and Ptch1 was observed in the embryonic limb buds and craniofacial processes. These findings provide additional evidence that prenatal PBO exposure targeting Shh pathway activity can result in malformations in mice that parallel common etiologically complex human birth defects.

A Primer on Human Birth Theory.

In the 1970s Massimo Fagioli (1931-2017) proposed a new theory of mind that he called the Human Birth Theory, based on a healthy conception of the baby and of the nonconscious mind. Fagioli made significant contributions to the understanding of mental dynamics at birth, the pathophysiology of mental illness, and the nonconscious identity of psychiatrists and psychotherapists. His original contributions to psychodynamic psychotherapy included variations on the setting and understanding of transference and dream interpretations that deviated from classical psychoanalytic techniques. This article introduces the basic tenets of Human Birth Theory, its neuropsychiatric correlates, and clinical applications.

Effect of an Intrapartum Pelvic Dilator Device on Levator Ani Muscle Avulsion During Primiparous Vaginal Delivery: A Pilot Randomized Controlled Trial

Introduction and HypothesisThe objective was to evaluate the safety and effectiveness of an intrapartum electromechanical pelvic floor dilator designed to reduce the risk of levator ani muscle (LAM) avulsion during vaginal delivery.MethodsA multicenter, randomized controlled trial enrolled nulliparous participants planning vaginal delivery. During the first stage of labor, participants were randomized to receive the intravaginal device or standard-of-care labor management. The primary effectiveness endpoint was the presence of full LAM avulsion on transperineal pelvic-floor ultrasound at 3 months. Three urogynecologists performed blinded interpretation of ultrasound images. The primary safety endpoint was adverse events (AEs) through 3 months.ResultsA total of 214 women were randomized to Device (n = 113) or Control (n = 101) arms. Of 113 Device assignees, 82 had a device placed, of whom 68 delivered vaginally. Of 101 Control participants, 85 delivered vaginally. At 3 months, 110 participants, 46 Device subjects who received full device treatment, and 64 Controls underwent ultrasound for the per-protocol analysis. No full LAM avulsions (0.0%) occurred in the Device group versus 7 out of 64 (10.9%) in the Control group (p = 0.040; two-tailed Fisher’s test). A single maternal serious AE (laceration) was device related; no neonate serious AEs were device related.ConclusionsThe pelvic floor dilator device significantly reduced the incidence of complete LAM avulsion in nulliparous individuals undergoing first vaginal childbirth. The dilator demonstrated an acceptable safety profile and was well received by recipients. Use of the intrapartum electromechanical pelvic floor dilator in laboring nulliparous individuals may reduce the rate of LAM avulsion, an injury associated with serious sequelae including pelvic organ prolapse.

Periconceptional maternal supplement intake and human embryonic growth, development, and birth outcomes: the Rotterdam Periconception Cohort.

Is periconceptional multiple-micronutrient supplement (MMS) use including folic acid (FA) compared to FA use only associated with increased embryonic growth, development, and birth weight in a high-risk population? Women with MMS intake show no significant differences in first-trimester morphological embryo development, but increased first-trimester embryonic growth trajectories and fewer neonates born small for gestational age (SGA), less than the 3rd percentile (<p3), compared to women using only FA. Periconceptional maternal FA intake in the general population is associated with increased embryonic and fetal growth, and reduced risks of neural tube defects, other congenital malformations, low birth weight, and neonates born SGA. A prospective tertiary hospital-based cohort study (the Rotterdam Periconceptional Cohort) was conducted from January 2010 to December 2020. We included 1076 women from the Rotterdam Periconceptional Cohort, before 10 weeks of pregnancy with follow-up until delivery. Embryonic growth was assessed by measurement of crown-rump length (CRL) and embryonic volume (EV), and embryonic morphology was described by Carnegie stages using longitudinal three-dimensional ultrasound scans and virtual reality techniques. Birth outcomes were extracted from medical records. General characteristics and supplement use were extracted from research questionnaires. This study showed increased embryonic growth trajectories (adjusted models, CRL: β = 0.052, 95% CI 0.012-0.090, EV: β = 0.022, 95% CI 0.002-0.042) in women using MMS compared to those using only FA. Moreover, a 45% reduced risk of a neonate-born SGA (<p3) was shown in women using MMS compared to FA users (adjusted OR = 0.546, 95% CI 0.308, 0.969). Embryonic morphological development (Carnegie stages) and the occurrence of miscarriages did not differ between women using MMS or solely FA. Following the heterogeneity of the composition and dose of MMS preparations, it is unclear which specific micronutrient, combination, or dose explains the increased embryonic growth trajectory and reduction in risk for SGA. This also hampers the possibility of differentiating between the effects of FA alone or as a component of MMS. Our findings emphasize the importance of periconceptional maternal MMS use as a potential preventative intervention against reduced embryonic growth and neonates born SGA. Therefore, we recommend the periconceptional use of MMS in women at risk of inadequate micronutrient intake. However, awareness of potentially harmful side effects of high doses and combinations of micronutrients is essential, therefore the optimal composition and dose need to be investigated, and careful surveillance is recommended. This research was funded by the Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands, and the ZonMw grant Open Competition 2018 (09120011910046). The authors declare that they have no conflict of interest. NTR4356.

Myringoplasty Using Human Birth Tissue Allografts to Repair Large Tympanic Membrane Perforations.

Examine outcomes among a series of pediatric patients who underwent myringoplasty using human birth tissue (BT) for repair of large tympanic membrane (TM) perforations. Case series. Single-institution pediatric hospital. Retrospective chart review of patients treated with BT during a 4-year study period. Subjects who underwent myringoplasty for large (size 40% or greater) TM perforations were included for this study. Patients with a stable perforation of at least 1 month's duration preoperatively who then followed up for at least 3 months postoperatively met inclusion criteria. Six subjects were included in this study. One subject underwent bilateral repair; thus, this series includes a total of 7 perforations. TM perforations ranged from 40% to 70% of the TM. At initial follow-up (median of 2 months), 5 of the 7 perforations had healed. One of these 5 had evidence of a 10% recurrent perforation at 5 months, which subsequently healed. Of the 2 patients not healed at initial follow-up, 1 had only a residual pinpoint perforation that subsequently healed; the other had a persistent 30% perforation that was possibly related to their postoperative recovery period, which was complicated by a respiratory viral illness. For large TM perforations, myringoplasty with BT grafts may be a viable alternative to longer, more invasive procedures like tympanoplasty. Larger, randomized, prospective studies are needed.

The Concept of Multiple Intelligence Education From the Quran's Perspective

This research aims to understand the Koran's view of Multiple Intelligences. This research is a literature study that collects data from books, magazines, articles, and works related to the formation of multiple intelligences from the perspective of the Al-Quran. In the Koran, human intelligence is related to faith and religious values. Every child own differences in intelligence. The Qur'an's view of various types of intelligence in Gardner's theory of multiple intelligence is not caused by the evolution of intelligence as proposed by Gardner but has existed since the birth of humans and their natural development. Apart from strengthening this argument, it also criticizes the spiritual references of Gardner's theory of multiple intelligences. This research concludes that each person has a different level of intelligence and continues to develop. According to Gardner, there are nine basic bits of intelligence: verbal intelligence, logical-mathematical intelligence, visual-spatial intelligence, kinesthetic intelligence, musical intelligence, interpersonal intelligence, intrapersonal intelligence, and natural and spiritual intelligence. The Al-Quran reveals language intelligence in surah al-Baqarah verses 31-33 and logical-mathematical intelligence in surah al-Ankabut verse 43. Human visual-spatial intelligence brought by Allah SWT is exposed in surah Hud 37-38 and the Qur'an. A shows human kinesthetic intelligence in surah al-Maidah 31. Allah gave humans rhythmic-musical intelligence to recite the holy verses of the Koran in a beautiful and linguistic style. In surah al-Hujarat verse 13 there is talk about interpersonal intelligence which shows the differences between humans. Allah intrapersonal signals in surah Zariyat 21 and naturalist intelligence in surah Ali Imran 190-191. God's intelligence is demonstrated existentially in surah Zariyat 56.

Urinary polycyclic aromatic hydrocarbon (PAH) metabolite concentrations in three pregnancy cohorts from 7 U.S. study sites.

Prenatal exposure to polycyclic aromatic hydrocarbons (PAHs) is associated with adverse birth and developmental outcomes in children. We aimed to describe prenatal PAH exposures in a large, multisite U.S. consortium. We measured 12 mono-hydroxylated metabolites (OH-PAHs) of 7 PAHs (naphthalene, fluorene, phenanthrene, pyrene, benzo(c)phenanthrene, chrysene, benz(a)anthracene) in mid-pregnancy urine of 1,892 pregnant individuals from the ECHO PATHWAYS consortium cohorts: CANDLE (n = 988; Memphis), TIDES (n = 664; Minneapolis, Rochester, San Francisco, Seattle) and GAPPS (n = 240; Seattle and Yakima, WA). We described concentrations of 8 OH-PAHs of non-smoking participants (n = 1,695) by site, socioeconomic characteristics, and pregnancy stage (we report intraclass correlation coefficients (ICC) for n = 677 TIDES participants). Exposure to the selected PAHs was ubiquitous at all sites. 2-hydroxynaphthalene had the highest average concentrations at all sites. CANDLE had the highest average concentrations of most metabolites. Among non-smoking participants, we observed some patterns by income, education, and race but these were not consistent and varied by site and metabolite. ICCs of repeated OH-PAH measures from TIDES participants were ≤ 0.51. In this geographically-diverse descriptive analysis of U.S. pregnancies, we observed ubiquitous exposure to low molecular weight PAHs, highlighting the importance of better understanding PAH sources and their pediatric health outcomes attributed to early life PAH exposure.

Uterus Transplantation: the Translational Evolution of a Clinical Breakthrough.

Women suffering from absolute uterine factor infertility (AUFI), due to either lack of a uterus or one unable to sustain neonatal viability, presented as one of the last frontiers in conquering infertility. Following systematic animal research for over a decade, uterus transplantation was tested as a treatment for AUFI in 2012, which culminated in the first human live birth in 2014. The development of uterus transplantation from mouse to human has followed both the Moore criteria for introduction of a surgical innovation and the IDEAL concept for evaluation of a novel major surgical procedure. In this article we review the important preclinical animal and human studies that paved the way for the successful introduction of human uterus transplantation a decade ago. We discuss this in the context of the Moore criteria and describe the different procedures of preparation, surgeries, postoperative monitoring, and use of assisted reproduction in human uterus transplantation. We review the worldwide activities and associated results in the context of the IDEAL concept for evaluation of surgical innovation and appraise the ethical considerations relevant to uterus transplantation. We conclude that rigorous application of the Moore criteria and strict alignment with the IDEAL concept have resulted in the establishment of uterus transplantation as a novel, safe, and effective infertility therapy that is now being used worldwide for the treatment of women suffering from AUFI.

Potency Campaign Madurese Culture Through Gastronomy Diplomacy

Gastronomy is a very complex cultural product. The development of gastronomic tourism contributes to strengthening local identity, and will be an important point for the development of sustainable tourism. In gastro-tourism, the main motivation for someone to travel is to get the experience of tasting food and drinks that can provide impressions and memories throughout their life. This research aims to explain the role of gastronomy in campaigning for Madurese culture. This research was conducted using the Life Story method and a gastrodiplomacy study approach. The results of the research show that the eating tradition in Madura is almost carried out on various occasions, from human births to funeral ceremonies. The tradition of eating is a space for people to gather in various elements to exchange ideas and thoughts. The potential for gastronomy as a space for Madurese cultural campaigns is still very wide open. This is related to the unique gastronomic characteristics of Madurese food and can be an interesting topic of conversation at a meeting. This research suggests that it is applicable to hold activities such as MICE-Meeting Incentive Convention and Exhibition with a food theme to become a sustainable Madurese cultural space campaign .

Placental somatic mutation in human stillbirth and live birth: A pilot case-control study of paired placental, fetal, and maternal whole genomes

IntroductionA high frequency of single nucleotide somatic mutations in the placenta has been recently described, but its relationship to placental dysfunction is unknown. MethodsWe performed a pilot case-control study using paired fetal, maternal, and placental samples collected from healthy live birth controls (n = 10), live births with fetal growth restriction (FGR) due to placental insufficiency (n = 7), and stillbirths with FGR and placental insufficiency (n = 11). We quantified single nucleotide and structural somatic variants using bulk whole genome sequencing (30-60X coverage) in four biopsies from each placenta. We also assessed their association with clinical and histological evidence of placental dysfunction. ResultsSeventeen pregnancies had sufficiently high-quality placental, fetal, and maternal DNA for analysis. Each placenta had a median of 473 variants (range 111–870), with 95 % arising in just one biopsy within each placenta. In controls, live births with FGR, and stillbirths, the median variant counts per placenta were 514 (IQR 381–779), 582 (450–735), and 338 (245–441), respectively. After adjusting for depth of sequencing coverage and gestational age at birth, the somatic mutation burden was similar between groups (FGR live births vs. controls, adjusted diff. 59, 95 % CI -218 to +336; stillbirths vs controls, adjusted diff. −34, −351 to +419), and with no association with placental dysfunction (p = 0.7). DiscussionWe confirmed the high prevalence of somatic mutation in the human placenta and conclude that the placenta is highly clonal. We were not able to identify any relationship between somatic mutation burden and clinical or histologic placental insufficiency.

A Novel Dehydrated Human Umbilical Cord Particulate Medical Device: Matrix Characterization, Performance, and Biocompatibility for the Management of Acute and Chronic Wounds.

Chronic wounds present a significant socioeconomic burden forecasted to increase in prevalence and cost. Minimally manipulated human placental tissues have been increasingly employed and proven to be advantageous in the treatment of chronic wounds, showing improved clinical outcomes and cost-effectiveness. However, technological advances have been constrained by minimal manipulation and homologous use criteria. This study focuses on the characterization of a novel dehydrated human umbilical cord particulate (dHUCP) medical device, which offers a unique allogeneic technological advancement and the first human birth tissue device for wound management. Characterization analyses illustrated a complex extracellular matrix composition conserved in the dHUCP device compared to native umbilical cord, with abundant collagens and glycosaminoglycans imbibing an intricate porous scaffold. Dermal fibroblasts readily attached to the intact scaffold of the dHUCP device. Furthermore, the dHUCP device elicited a significant paracrine proliferative response in dermal fibroblasts, in contrast to fibrillar collagen, a prevalent wound device. Biocompatibility testing in a porcine full-thickness wound model showed resorption of the dHUCP device and normal granulation tissue maturation during healing. The dHUCP device is a promising advancement in wound management biomaterials, offering a unique combination of structural complexity adept for challenging wound topographies and a microenvironment supportive of tissue regeneration.

Tranexamic acid versus oxytocin prophylaxis in reducing post-partum blood loss, in low-risk pregnant women: TRANOXY STUDY, a phase III randomized clinical trial

To assess the equivalence of tranexamic acid (TRAN) versus synthetic oxytocin (OXY) in reducing post-partum blood loss, in full-term patients (37-42 weeks), at low risk of post-partum hemorrhage, with vaginal childbirth. Phase III, randomized (1:1), open-label, longitudinal, multi-center, prospective clinical trial (Prot. n 63209, ClinicalTrials.gov Identifier: NCT02775773). From January 7, 2020, to June 30, 2023, a total of 256 women were enrolled at two general urban community hospitals in Italy, serving a multi-ethnic patient population with National Health Insurance. The primary outcome was to explore a potential equivalence between the two treatments (OXY and TRAN) in preventing total blood loss. Therefore, we randomized 231 women into two groups: Group A (OXY), 127 women who were administered 10UI intramuscularly within 5min from childbirth; Group B (TRAN), 104 women to whom 1-g slow intravenous infusion was administered within 5min from childbirth. At the time of delivery, mean blood loss for OXY group versus TRAN group was 269.12mL versus 263.88mL, respectively, with equivalence between the two groups. Similarly, there was equivalence in total blood loss between the OXY and the TRAN group (397.66mL versus 405.64mL, respectively. No statistical differences between Hb levels at admission and discharge in the two groups were reported. No difference was found in terms of additional uterotonic and surgical therapies between the two groups of patients. Neither group showed thrombotic complications at check-up performed after 7 days or after a questionnaire regarding adverse effects, subjected after 40 days. The study shows the equivalence of tranexamic acid versus synthetic oxytocin in post-partum blood loss prophylaxis in term patients at low risk of PPH with vaginal childbirth. The safety profiles of OXY and TRAN were similar. None.

Zebrafish Congenital Heart Disease Models: Opportunities and Challenges.

Congenital heart defects (CHDs) are common human birth defects. Genetic mutations potentially cause the exhibition of various pathological phenotypes associated with CHDs, occurring alone or as part of certain syndromes. Zebrafish, a model organism with a strong molecular conservation similar to humans, is commonly used in studies on cardiovascular diseases owing to its advantageous features, such as a similarity to human electrophysiology, transparent embryos and larvae for observation, and suitability for forward and reverse genetics technology, to create various economical and easily controlled zebrafish CHD models. In this review, we outline the pros and cons of zebrafish CHD models created by genetic mutations associated with single defects and syndromes and the underlying pathogenic mechanism of CHDs discovered in these models. The challenges of zebrafish CHD models generated through gene editing are also discussed, since the cardiac phenotypes resulting from a single-candidate pathological gene mutation in zebrafish might not mirror the corresponding human phenotypes. The comprehensive review of these zebrafish CHD models will facilitate the understanding of the pathogenic mechanisms of CHDs and offer new opportunities for their treatments and intervention strategies.