Intrauterine Life Research Articles

Histomorphological Development Study of Cecum in Local Awassi Sheep Fetuses (Ovis Aris): Prenatal Periods

This study was conducted at Al-Qasim Green University/College of Veterinary Medicine, Anatomy and Histology Branch. The experiment was designed to study the cecum of Awassi sheep fetuses: prenatal periods. Samples (30 male and female samples) were collected from healthy females uterine and divided according to age groups into four groups by crown rump length formula (CRL) for the prenatal stage. In the first age group (50-55), the cecum was in the process of development, as it was not distinguished visually. In the second age group (70-75 days), it was a small protrusion located between the ileum and the beginning of the ascending colon. With advancing age, the third group, which includes two ages in the third trimester of pregnancy, we found that the cecum was completely formed in (100-105) days and at (130-140) days of gestation. Also, upon histological study, we found that the wall of the cecum consists of four layers, as in the rest of the parts of the digestive system, and is lined with an epithelial layer surrounded by a layer of connective tissue. It is supportive of the epithelial tissue. We also found tunica submucosa constantly devolving with age, as it is mesenchymal cells in the first stage of intrauterine life and begin to transform into connective tissue with the presence of fibers and collagen (tunica submucosa) as a result of these cells transforming into spindle cells to form the inner muscle layer, as well as tunica muscularis externa. The latter is surrounded by loose connective tissue that contains a few collagen and elastic fibers surrounded by mesothelial cells (tunica serosa) that contain blood vessels to support development in the inner layers.

Anatomical variations and embryological basis of arch of aorta and aortic valve.

Variations in the arch of the aorta and aortic valves among fetal, cadaveric, and post-mortem specimens present a spectrum of anatomical configurations, posing challenges in establishing a standard norm. While some variations hold surgical significance, many bear little functional consequence but provide insights into embryological origins. The aortic arch exhibits diverse branching patterns, including common trunks and different orders, relevant for endovascular surgeries. Meanwhile, malformations in the aortic valve, affecting the aorta, may lead to ischemia and cerebral infarction, warranting understanding of coexisting arch and valve anomalies to predict complications like aortic dissection. Studies in the Indian population mirror global variations, underscoring the need to explore embryological, clinical, and surgical implications for safer vascular surgeries involving the aortic arch and valves. The study's objectives included examining branching patterns, diameters, and distances between arch branches and exploring aortic valve variations. Employing a cross-sectional design, the study was conducted across Anatomy, Forensic Medicine, and Obstetrics and Gynecology departments. A sample of 100, comprising cadavers, fetuses, and postmortem specimens, were gathered. Specimens ranged from 14weeks of intrauterine life to 85years, with intact thoracic cages as inclusion criteria. Methodology involved dissection, specimen fixation, and macroscopic examination for variations and morphological parameters. Results showed aortic diameter increase with age, with significant gender differences. A statistically significant association between arch variations and anomalous valves was observed, suggesting mutual predictability. Individuals with valve anomalies should undergo comprehensive cardiology evaluation to avert complications like aortic dissection during endovascular surgeries. While atheromatous plaques were prevalent in younger groups, their frequency rose with age, necessitating vigilant vascular monitoring. Careful handling during surgeries is paramount, given potential adverse outcomes resulting from variations. Overall, the study underscores the importance of comprehensive anatomical understanding in clinical contexts, guiding effective management strategies and ensuring patient safety in vascular surgeries.

Congenital Single Digit Deformities: Series of Cases in Multiple Families in Remote Villages of Haryana

Abstract Background and Purpose: Congenital deformities occur due to abnormal development of limbs in the intrauterine life. The exact cause of this type of defect is not known but can be associated with environmental factors (drug history or exposure of chemical effluents from factory) or genetic predisposition. Cases involving the occurrence of single digits in all four limbs were witnessed, and the aim was to study and trace the cause of such deformities. Knowledge of thalidomide induced phocomelia which has already being published in the literature also contributed to our knowledge and understanding. Objectives: (1) Primary objective was to identify the causative agent or genetic factor for the occurrence of single digits in hands and feet in multiple families. (2) Secondary objective was to create awareness among patients and the general public as well as local government authorities regarding such families of “Divyang” patients. We present a case series of multiple families with complete absence of all fingers and toes except one across villages in Haryana. Materials and Methods: Clinical setting: (1) Study was based on a detailed questionnaire which was taken from multiple villagers (Tarawari Village, Nilokheri Village, etc.) and (2) phenotypic examination. Five affected patients from multiple families for 1 year were taken for study from March 2022 to March 2023. Their habitus, lifestyle, and environmental status were all studied and compared with other studies. Efforts were taken to study the license and toxic effluent treatment plan of a chemical factory present in the near vicinity. Results: A strong genetic association was suggested for the occurrence of single digits in the hands and feet of multiple patients across multiple villages close to a chemical factory. They have well adjusted with writing, eating, riding bikes, and four-wheelers with single fingers and toes. Conclusion: There is a need to establish genetic analysis so that the cause of such deformities could be known and prevented. There is also a need for general and government awareness toward pollutants released from chemical factories and their effects.

Prevalence of Transitional Vertebra in Lumbar Disc Herniation in Bangabandhu Sheikh Mujib Medical University

Background: Lumbosacral transitional vertebrae (LSTV) occur as a congenital anomaly in the segmentation of lumbosacral spine that occur during intrauterine life. LSTV includes lumbarization and sacralization of the lumbosacral region. A transitional vertebra(TV) may have varying formations, the common feature being an atypical lumbosacral articulation between transverse process of the most inferior lumbar vertebra and the sacrum. There has been a lot of discussion regarding the prevalence of LSTV in lumbar disc herniation(LDH). Most of the studies showed increased prevalence while other studies showed TV is an incidental finding and there is no increased prevalence in LDH. LDH is a quiet common ailment encountered in neurosurgical practice. Numerous causes have been attributed to it. LSTV might have great importance in patients who clinically seem to have LDH where it’s presence in plain X-ray might provide a supportive evidence for diagnosis and it can help to counsel the patient. We will be able to recommend a plain x-ray of lumbosacral spine first, having history and clinical findings suggestive of LDH and can save the cost of MRI investigation until decision for operation. Beside this LSTV is an important entity for spinal surgeons , radiologists and also for those who do interventional procedures in the spine. For this reason the prevalence of TV in LDH should be known. This study was not carried out in our country yet. So this study will enrich our demographic information and will also help the spinal surgeons to counsel the patients about their congenital spinal morphological variation and different facts related with this. Objectives: General objective of this study is to observe the prevalence of LSTV in patients with LDH. Specific objective of this study was to identify the diathroidal joint or fusion between transverse process of last lumbar vertebra and ala of sacrum, to count the vertebral number from C2 to S1 in whole spine screening film, to identify the transitional vertebra as sacralization or lumbarization or absence of TV, to predict the future possibility of development of LDH from plain X-ray of lumbosacral spine. Methods: This study was a cross sectional type of observational study and was conducted in Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University (BSMMU). The patients (N=45) who fulfilled the selection criteria was enrolled in this study. Patient’s data were recorded in a predetermined data sheet. Patients were informed in details about the study, its merits and demerits in easy and understandable language and then informed consent was taken. Also assurance was given that all the information and records would be kept confidential and the study result would help the neurosurgeons to counsel the patients with LSTV about future possibility of development of LDH from plain X-ray of lumbosacral spine. This study was not responsible for any additional harm to the patient and study had no potential risk to the patient and no experimental drugs were used in this study. Results: A total of 45 patients of LDH were studied to see the prevalence of lumbosacral TV in LDH. Based on history and clinical findings, 100% of patients presented with low back pain, 100% of patients presented with sciatica, and 62.2% presented with gait difficulty and 02.2% of patients presented with cauda equina syndrome. Mean age of patients having LDH herniation was 38.08 ± 10.15 years. LSTV was found in 31.11% of patients with LDH. In this study, LSTV was diagnosed by plain X ray of Lumbosacral spine (A/P view) and supplemented with MRI of L/S spine with screening of whole spine (in most cases). Diagnosis of transitional vertebra was done by researcher and was further confirmed by guide and faculty members of BSMMU. In relation to gender, prevalence of LSTV in male was 25.9% and in female was 38.9% which indicated higher prevalence of TV in female but this is not statistically significant (p value 0.356).Incidence of disc herniation in patients with TV was at the space above the transition in 85.7% of cases. The most likely explanation for this is that the motion segment cephalad to the LSTV has to bear additional stresses by virtue of it being juxtaposed to a relatively non-mobile segment Conclusion: This study reveals that the prevalence of LSTV in LDH is 31.11% which is near the upper limit of its prevalence(according to literature). Association of TV with LDH can not be obtained as a control group of patient without LDH was not considered. So further study should be carried out incorporating large number of patients with control group with long study period to generalize the findings to target population. Bang. J Neurosurgery 2023; 12(2): 76-85

Intra-uterus phthalate exposure, ROS formation and altered mitochondrial D-loop methylation pattern at birth as potential triggers and markers of Alzheimer’s disease

Alzheimer's Disease is one of the fastest growing causes of dementia, and the factors that trigger its pathology have not yet been completely unraveled. In addition, Alzheimer's disease (AD) impacts not only the individual affected, but also the familial and socio-economic spheres. On the other hand, phthalates are plasticizers capable of interfering with the endocrine system and which, due to the nature of the most varied objects, utensils and tools used by society, as well as the propensity of these chemicals to dissociate from their matrices and accumulate in the environment and living organisms, are frequently and in large quantities exposed to humans. This study explores a possible relationship between exposure to phthalates and the development of Alzheimer's pathophysiology, with emphasis on prenatal exposure and its influence on the risk of dementia in adulthood. Based on the literature consulted, mechanisms for the generation of oxidative stress in the nervous system by phthalates were described and it was proposed how this could be related to the triggering of Alzheimer's pathophysiology, primarily in view of the modification of the methylation pattern of mitochondrial DNA. In addition, it was observed that exposure to phthalates during intrauterine life is capable of generating changes in the epigenetic pattern at birth. An alternative for the early detection of mitochondrial metabolic dysfunctions, which could potentially evolve into dementia, could involve monitoring D-loop methylation levels. Therefore, we hypothesized that intrauterine exposure to phthalates may generate oxidative stress in the brain and alter the mtDNA methylation pattern, which can perturb mitochondrial function and increase risk of development of AD at adulthood. We suggest that these phthalate-induced metabolic changes may be detected by the D-loop methylation pattern at birth. We highlight the need for more research integrating the emerging fields of mitoepigenetics and bioenergetic medicine with neurodegenerative diseases, and an experimental design employing zebrafish as a model is suggested to test the hypotheses raised.

MicroRNA in cardiometabolic health and disease: The perspectives of sex, gender and personalised medicine.

Personalized medicine represents a novel and integrative approach that focuses on an individual's genetics and epigenetics, precision medicine, lifestyle and exposures as key players of health status and disease phenotypes. In this narrative review, we aim to carefully discuss the current knowledge on gender disparities in cardiometabolic diseases, and we consider the sex- specific expression of miRNAs and their role as promising tool in precision medicine. Personalised medicine overcomes the restricted care of patient based on a binomial sex approach, by enriching itself with a holistic and dynamic gender integration. Recognized as a major worldwide health emergency, cardiometabolic disorders continue to rise, impacting on health systems and requiring more effective and targeted strategies. Several sex and gender drivers might affect the onset and progression of cardiometabolic disorders in males and females at multiple levels. In this respect, distinct contribution of genetic and epigenetic mechanisms, molecular and physiological pathways, sex hormones, visceral fat and subcutaneous fat and lifestyle lead to differences in disease burden and outcomes in males and females. Sex and gender play a pivotal role in precision medicine because the influence the physiology of each individual and the way they interact with environment from intrauterine life.

Impact of Maternal Environment and Inflammation on Fetal Neurodevelopment.

During intrauterine life, external stimuli including maternal nutrition, lifestyle, socioeconomic conditions, anxiety, stress, and air pollution can significantly impact fetal development. The human brain structures begin to form in the early weeks of gestation and continue to grow and mature throughout pregnancy. This review aims to assess, based on the latest research, the impact of environmental factors on fetal and neonatal brain development, showing that oxidative stress and inflammation are implied as a common factor for most of the stressors. Environmental insults can induce a maternal inflammatory state and modify nutrient supply to the fetus, possibly through epigenetic mechanisms, leading to significant consequences for brain morphogenesis and neurological outcomes. These risk factors are often synergic and mutually reinforcing. Fetal growth restriction and preterm birth represent paradigms of intrauterine reduced nutrient supply and inflammation, respectively. These mechanisms can lead to an increase in free radicals and, consequently, oxidative stress, with well-known adverse effects on the offspring's neurodevelopment. Therefore, a healthy intrauterine environment is a critical factor in supporting normal fetal brain development. Hence, healthcare professionals and clinicians should implement effective interventions to prevent and reduce modifiable risk factors associated with an increased inflammatory state and decreased nutrient supply during pregnancy.

Prenatal Diagnosis by Trio Clinical Exome Sequencing: Single Center Experience.

Fetal anomalies, characterized by structural or functional abnormalities occurring during intrauterine life, pose a significant medical challenge, with a notable prevalence, affecting approximately 2-3% of live births and 20% of spontaneous miscarriages. This study aims to identify the genetic cause of ultrasound anomalies through clinical exome sequencing (CES) analysis. The focus is on utilizing CES analysis in a trio setting, involving the fetuses and both parents. To achieve this objective, prenatal trio clinical exome sequencing was conducted in 51 fetuseses exhibiting ultrasound anomalies with previously negative results from chromosomal microarray (CMA) analysis. The study revealed pathogenic variants in 24% of the analyzed cases (12 out of 51). It is worth noting that the findings include de novo variants in 50% of cases and the transmission of causative variants from asymptomatic parents in 50% of cases. Trio clinical exome sequencing stands out as a crucial tool in advancing prenatal diagnostics, surpassing the effectiveness of relying solely on chromosomal microarray analysis. This underscores its potential to become a routine diagnostic standard in prenatal care, particularly for cases involving ultrasound anomalies.

IJCM_359A: Pattern of Congenital Anomalies among newborn babies - A Hospital based study

Background: Congenital anomalies can be defined as structural or functional anomalies that occur during intrauterine life and can be identified prenatally. Some of the congenital anomalies may be life threatening, hence an immediate management is required. This study is to determine the pattern of congenital anomalies among newborn babies and factors associated with it. Methodology: It was a descriptive study carried out at KMC Hospital, Attavar on all the new born babies with congenital abnormalities born or admitted in KMC Attavar. Data extraction sheet had two sections including the maternal details, history of newborn related to type of congenital anomalies and condition of the baby at birth. Data was entered and analyzed by using statistical software Statistical Package for Social Sciences (SPSS) Version 11.5. Descriptive statistics like mean, proportions and standard deviation was used for expressing the results. Results: We found that 56.25% of the cases were of maternal age group <30years. 3.16% were non-consanguinous marriages, 56.46% of mothers were primiparous & 43.53% were multiparous. Only 18.40% had maternal co morbidities & 5.84% had hazardous exposure. 67% of the study population were males and 33% were females. In cases where single system was involved, 66.85% were males and 33.15% were females. In cases with multiple malformations, 67.56% were males and 32.43% were females. In the cases where maternal age was <30yrs, 22.85% of anomalies were in the cardiovascular system, and in ≥30yr, 29.63% were multiple malformations. Conclusion: Among the congenital anomalies affecting the newborns, the most affected single system is gastrointestinal tract followed by cardiovascular system and musculoskeletal system. Multiple malformations were found to be the highest. Congenital anomalies were found to be more in males than females. In maternal age group of less than 30yrs, highest number of anomalies were in the cardiovascular system and for more than/equal 30yrs, highest number was multiple malformations.

Gestational diabetes mellitus as a risk factor for neuropsychiatric pathology in offspring

This review article summarizes current ideas about gestational diabetes mellitus as an independent risk factor for long-term neuropsychiatric morbidity in offspring. Herein, we describe the genetic programming patterns of morphofunctional brain development during intrauterine life, which provide the basis for short- and long-term functions of the central nervous system. The results of experimental and clinical studies are presented that explain the pathophysiological mechanisms of the harmful effects on the fetal brain of hyperglycemia, hyperinsulinemia, hyperlepthyremia, oxidative stress, and systemic inflammation in the mother with pregnancy complicated by diabetes mellitus. We also discuss structural brain abnormalities and neuropsychiatric consequences. The article substantiates the need for the prevention of neuropsychiatric diseases in the offspring of women with obesity and other concomitant pathology at the stage of family planning, and at the onset of pregnancy, the expediency of early screening, treatment of gestational diabetes mellitus and neuroprotection in the perinatal period of the child’s life.

Does Bisphenol-A play a role in the development of neural tube defects?

In this study, we aimed to evaluate BPA levels in the maternal serum and amniotic fluid of patients diagnosed with NTD. In addition, we wanted to investigate the relationship between neurodevelopmental defects, such as neural tube defects (NTD), and BPA levels. This prospective observational study was carried out at Bursa Yüksek İhtisas Training and Research Hospital between April 15, 2021, and April 15, 2022. The study consisted of 92 patients between the ages of 18-45 who had an amniocentesis at 15-22 weeks of gestation. The patients were divided into two groups according to the indications of amniocentesis. Group 1 contained the patients with abnormal maternal serum screening results or cell-free DNA results and abnormal ultrasonography findings (45 patients). Group 2 contained the patients with a pre-diagnosis of NTD (47 patients). The first 5 cc fluids and maternal serum samples taken during the amniocentesis procedure of all patients were delivered to the biochemistry laboratory. The BPA values between groups were compared. A statistically significant difference was found between the two groups in terms of amniotic fluid BPA levels (36.66 (19.00:82.00) and 39.62 (19.02-73.87)) and maternal blood BPA levels (22.26 (12.60-228) and 47.81 (12.89-228.39)). In cases with NTD, amniotic fluid BPA levels and maternal blood BPA levels were significantly higher than the control group. When AUC values were compared, the AFP numerical value was higher than the amniotic fluid and maternal blood BPA levels. Plastic, which is indispensable for modern life, may negatively affect fetal development in intrauterine life. The data in this study says that high maternal blood BPA may be associated with NTD.

Knowledge and skills of newborn resuscitation among health care professionals in East Africa. A systematic review and meta-analysis.

Newborn resuscitation is a medical intervention to support the establishment of breathing and circulation in the immediate intrauterine life. It takes the lion's share in reducing neonatal mortality and impairments. Healthcare providers' knowledge and skills are the key determinants of the success of newborn resuscitation. Many primary studies have been conducted in various countries to examine the level of knowledge and skills of newborn resuscitation and associated factors among healthcare providers. However, these studies had great discrepancies and inconsistent results across East Africa. Hence, this review aimed to synthesize the pooled level of knowledge and skills of newborn resuscitation and associated factors among healthcare providers in East Africa. Studies were systematically searched from February 11, 2023, to March 10, 2023, using PubMed, Google Scholar, HINARI, and grey literature. The effect size measurement of knowledge and skill of health care newborn resuscitation was estimated using the Random Effect Model. The data were extracted by Excel and analyzed using Stata 17 software. The Cochran's Q test and I2 statistic were used to assess the heterogeneity of studies. The symmetry of the funnel plot and Egger's test were used to check for publication bias. A subgroup analysis was done on the study years, sample sizes, and geographical location. Percentages and odds ratios (OR) with 95% CI were used to pool the effect measure. In this systematic review and meta-analysis, a total of 1953 articles were retrieved from various databases and registers. Finally, 17 studies with 7655 participants were included. The overall levels of knowledge and skills of healthcare providers on newborn resuscitation were 58.74% (95% CI: 44.34%, 73.14%) and 46.20% (95% CI: 25.16%, 67.24%), respectively. Newborn resuscitation training (OR = 3.95, 95% CI: 2.82, 5.56) and the availability of newborn resuscitation guidelines (OR = 2.71, 95% CI: 1.90, 3.86) were factors significantly associated with knowledge of health care professionals on newborn resuscitation. Work experience (OR = 5.92, 95% CI, 2.10, 16.70), newborn resuscitation training (OR = 2.83, 95% CI, 1.8, 4.45), knowledge (OR = 3.05, 95% CI, 1.78, 5.30), and the availability of newborn resuscitation equipment (OR = 4.92, 95% CI, 2.80, 8.62) were determinant factors of skills of health care professionals on newborn resuscitation. The knowledge and skills of healthcare providers on newborn resuscitation in East Africa were not adequate. Newborn resuscitation training and the availability of resuscitation guidelines were determinant factors of knowledge, whereas work experience, knowledge, and the availability of newborn resuscitation equipment and training were associated with the skills of healthcare providers in newborn resuscitation. Newborn resuscitation training, resuscitation guidelines and equipment availability, and work experience are recommended to improve healthcare providers' knowledge and skills.

Critical Analysis of Effect of Garbhini Ahara During Prenatal Period on Growth & Development of a Child w.s.r to Panchmahabhoot Theory of Ayurveda

Objective: The objective of this review study is to understand the scientific concept behind relation of Ayurveda dietary regimen of mother during entire pregnancy mentioned in Samhitas with growth and development of child in purview of Panchmahabhoot theory. This study can also pave the path for Ayurveda scholars to understand the depth behind the concept of Masanumasik Vriddhi due to special dietary regimen mentioned in Ayurveda Samhitas. Data: Data for this study has been collected mainly from a variety of secondary and tertiary literature sources and online database like PubMed, Scopus available. Review Methods: Keeping the objective of study in mind, various Samhitas along with their commentaries have been reviewed. Various narrative and analytical articles have been referred to critically analyse the undefined concept of dietary regimen of pregnant lady in Ayurveda. Conclusion: The aptness in all Mahabhootas can result in promotion of good health status and its imbalance can result in various ailments. The same is true in case of intrauterine life. Panchmahabhoota can be considered as the basis of genetics in Ayurveda and so if by proper and sequential incorporation of Masanumasik Garbhini Ahara we can prevent as well as cure genetic disorders of fetus. This can improve quality of life of mother, fetus and can prevent the mishappening like miscarriages, abortions, fetal anomalies, post birth defects which are quiet obvious now-a-days.

Italian Guidelines for the diagnosis and treatment of Fetal Alcohol Spectrum Disorders: international diagnostic criteria - differences and similarities.

The umbrella term Fetal Alcohol Spectrum Disorders (FASD) brings together under its definition a heterogeneous continuum of disabilities linked by a common etiology and pathogenesis: exposure to alcohol during intrauterine life. Despite extensive research, definitive toxic thresholds remain elusive, underscoring the recommendation for complete alcohol abstinence during pregnancy and lactation. FASD poses diagnostic challenges due to its varied presentations and heterogeneous phenotype. Consequently, no singular diagnostic guideline exists, with multiple expert-driven diagnostic systems globally available. This review aims to synthesize recent and notable guidelines facilitating FASD diagnosis. While efforts were made to include the latest diagnostic systems, determining which scheme is best applied to each individual patient population necessitates clinician discretion. In Italy, the guidelines proposed by Hoyme, revised in 2016, are commonly utilized, yet comparative analysis among guidelines offers valuable insights into their historical context and diagnostic utility. Our discussion explores both similarities and discrepancies among systems for diagnosing FASD, shedding light on their evolution and practical application. The objective of our work was to compare in a practical and precise manner the various existing guidelines used globally regarding the diagnosis of FAS. Our review therefore proposes the diagnostic criteria used by the various working groups and compares them, trying to create a practical comparison between the various guidelines, identifying differences and similarities.

Large Epidermoid Cyst in Submental Region: A Rare Case Report

Epidermoid cyst, specially in large size is one of the rare lesions of maxillofacial region, affects submental and sublingual region. The cyst develops from the entrapment of pluripotent ectodermal and mesodermal primordia, in the embryonic lines of fusion, when first and second branchial arches of each fuse in the midline, between third and fourth weeks of intrauterine life. After entrapment, this tissue shows gradual proliferation and ultimately transform to a cyst. A 19-year-old-boy presented with such a midline painless large swelling in the submental and sublingual region with diagnosis of epi dermoid cyst. After enucleation, the patient didn’t show any recurrence after 2 years follow up. J Bangladesh Coll Phys Surg 2024; 42: 92-96

The Effects of General Anesthetics on the Developing Brain of Fetus

The Effects of General Anesthetics on the Developing Brain of Fetus

Birth Weight and Third-trimester Maternal Vitamins A, C, and E Levels

Background: Deficiencies of micronutrients (especially vitamins C, A, and E) during intra-uterine life have been linked with the possibility of increased risk of some diseases (e.g. cardiovascular disease and type 2 diabetes) in adulthood.
 Aims: Therefore, it becomes expedient that persistent and vigorous attention be paid to maternal vitamin status during gestation.
 Methodology: This is a cross-sectional comparative study carried out at maternity centres in Osogbo Local Government. Forty women who were at least 29 weeks of gestation and 40 apparently healthy women, age-matched, non-pregnant constituted the test and control groups respectively. Blood was obtained through an ante-cubital vein, centrifuged and used for vitamin estimations (High-Performance Liquid Chromatography). Birth weight and neonatal mortality ratio were the birth outcomes that were obtained. Data analysis was by Student’s t-test and Pearson’s correlation coefficient. P≤0.05 was considered significant.
 Results: Serum status of vitamins A (2.68±3.88 µg/dL); C (0.95±0.44 mg/dL); and E (0.67±0.04 mg/dL) were significantly lower at third trimester compared with the corresponding values of 6.98±1.26 µg/dL; 2.99±0.11 mg/dL; and 1.66±0.08 mg/dL among non-pregnant control. There were significant adverse pregnancy outcomes as signified by 10% stillbirths. In addition, low birth weight (1.5-2.4 kg) was observed among approximately 50% of the babies but no correlation was observed except between vitamins C and E.
 Conclusions: The results of this study revealed that among Nigerian pregnant women, there are risks of abnormal birth outcomes and low levels of vitamin A, C, and E. Aside depletions in vitamin C and E, the results of the study (r= .376; p= .020) suggest possible metabolic interaction between both.

Maternal Neudesin Levels in Pregnant Women with Gestational Diabetes Mellitus.

Our aim was to investigate the changes in neudesin levels in pregnant women with GDM and the relationship between neudesin and metabolic parameters. Forty pregnant women diagnosed with GDM and forty age- and gestational week-matched control subjects were included in the study. Demographic data were obtained from records. Maternal lipid profiles, glucose levels, fasting insulin, HbA1C, and HOMA-IR results were compared between the groups. Correlation tests were performed to evaluate the relationship between neudesin and clinical and laboratory diagnostic parameters. p < 0.05 were interpreted as statistically significant. The human serum neudesin levels were significantly lower in the GDM group compared with the controls. The correlation tests showed statistically negative and weak correlations between the neudesin levels and the maternal age, 50 g OGCT, 100 g OGTT 3 hours, and HbA1C. The optimum neudesin cutoff value for a diagnosis of GDM disease is 6.94 ng/dL, with a sensitivity of 65.9% and a specificity of 63.2%. This study has shown that lower neudesin levels may occur as a reflection of changes in glucose metabolism during intrauterine life.

Prevalence of Congenital Anomalies of the Upper Limbs in Brazil: a descriptive cross-sectional study.

Congenital Anomalies of the Upper Limb (CAUL) are a group of structural or functional abnormalities that develop during intrauterine life and can lead to limb dysfunction. To analyze the prevalence of congenital anomalies of the upper limbs in Brazil and assess maternal and neonatal variables. A cross-sectional, descriptive study was conducted on congenital upper limb malformations among live births across Brazil. The study spanned from 2010 to 2019. Data were sourced from the Department of Informatics of the Unified Health System (DATASUS) and the Live Birth Information System (SINASC) portal. Analyses focused on the information reported in field 41 of the Live Birth Declaration Form entered into the computerized system. The most common anomaly in Brazil was supernumerary fingers, classified as ICD-Q69.0, affecting 11,708 children, with a prevalence of 4.02 per 10,000 live births. Mothers aged over 40 years had a 36% higher prevalence of having children with CAUL than mothers under 40 years old (OR = 1.36; 95% CI 1.19-1.56). Newborns weighing ≥ 2,499 g were 2.64 times more likely to have CAUL compared to those weighing ≥ 2,500 g (OR = 2.64; 95% CI 2.55-2.73). There was an observed increase in the reporting of CAUL cases over the decade studied. This trend serves as an alert for health agencies, as understanding the prevalence of CAUL and its associated factors is crucial for preventive medicine.

Vaccination of pregnant women. The early protection of the newborn from the intrauterine life

Vaccination of pregnant women. The early protection of the newborn from the intrauterine life