Length Of Pregnancy Research Articles

ANALIZA MASY CIAŁA RÓZNYCH ODMIAN BARWNYCH NORKI AMERYKA ˙ NSKIEJ ´ (NEOVISON VISON) ORAZ OCENA ZALEZNO ˙ SCI POMI ˛EDZY MAS ˛A CIAŁA SAMIC ´ A UZYSKIWANYMI WSKAZNIKAMI ROZRODU

The aim of the study was to analyze the body weight of different color varieties of breeding mink and to assess the relationship between the body weight of females and the reproductive indexes obtained. The research material consisted of 3499 one-year-old American mink females of five color varieties: White Regal, Standard Black, Pearl, Silverblue and Black Cross. Six body-weight ranges of female mink were distinguished. The following were analyzed within each range: pregnancy length, fertility, average number of kits born in a litter, average number of kits born alive in a litter. It was also examined whether there was a relationship between the color variety and the average body weight of females attained during the pre-mating body condition adjustment. There were statistically significant differences in the body weight of the analyzed color varieties of mink. It was also found that the body weight of females obtained in the period of breeding preparation influences the resulting reproductive performance. Higher body weight positively influences fertility, while animals of an average body weight produce larger litters of kits.

Maternal determinants of gestation length in the rhesus monkey.

A gestation length of normal duration and natural delivery at term are considered to be important indicators of a healthy pregnancy, especially given the potentially adverse consequences for neonates of being born premature. While many have assessed the factors influencing gestation length in humans, and there has been considerable interest in the pregnancy duration of domesticated farm animals, this topic has not been re-assessed recently in rhesus monkeys, the most commonly used primate in biomedical research. In older articles, it's gestation length was typically reported to be 165 days, although most authors acknowledged that viable pregnancies could occur out to 180 days. Predicting the normal range of acceptable due dates has important veterinary implications for when to intervene in a prolonged pregnancy. Using archival records from a large, established breeding program, gestation lengths and infant birthweights were analyzed for 408 pregnancies across a 25-year period. The potential influence of maternal factors, including age and parity, was assessed. Familial concordance in gestation length within mother-daughter matrilines was examined, as well as similarity in length across repeat pregnancies for 84 multiparous females. Mean duration from mating to delivery was 168.8 days, longer than reported in most but not all previous articles. Many females birthed successfully at a longer duration that might have prompted consideration of a caesarian delivery. Gestation length for an individual female was fairly stable and significantly correlated across multiple pregnancies. There was not a pronounced transgenerational influence on gestation length even though familial propensities for birthing small and large infants were evident in the female descendants. Typical pregnancy lengths and birthweights are provided as reference norms to assist other breeding programs and to enhance our understanding of the natural reproduction of rhesus macaques that still live in many forested and urban locations across South Asia.

The relationship between umbilical cord measurements and newborn outcomes

Objective This study investigated the relationship between umbilical vein diameter and cord length and fetal outcome in low-risk pregnancies (fetuses appropriate for gestational age [AGA]). Methods A prospective cohort study of 39 singleton pregnant women aged 19–44 years at between 38+0 and 41+6 weeks of gestation was conducted. Case demographics, umbilical vein diameter measured by prenatal ultrasound, postnatal birth weight, gender, 1- and 5-minute Apgar scores, blood gas analysis, and umbilical cord length were recorded. Fetuses with a fetal weight in the 10–90th percentile according to week of gestation were accepted as AGA. Results The mean age of the pregnant women was 27.5±5.3 years. 33% (13/39) of the pregnant women were nulliparous. There was no statistically significant correlation between umbilical vein diameter and other variables in correlation analysis (p>0.050). Umbilical cord length and umbilical vein lactate level were found to have a statistically negative and significant correlation (r=-0.418; p=0.015); however, no other pregnancy outcomes were found to have a significant correlation. There was no statistically significant difference between the median values of umbilical vein diameter and cord length by gender (p=0.076 and 0.181, respectively). Conclusion In conclusion, this study found no relationship between umbilical vein diameter and cord length and fetal weight and pregnancy outcome in low-risk 38.0–41.6-week pregnancies (AGA fetuses). However, the obtained results still need to be confirmed by larger series.

Midwifery Care for Pregnant Women in the Third Trimester with Complaints of a Flat Stomach at the Clinic

Pregnancy is a condition in which there is an embryo or fetus in the womb of a woman. The gestation period starts from conception until the fetus is born. First Day of Last Menstruation is used to calculate the normal length of pregnancy which is 280 days (40 weeks or 9 months 7 days). Complaints of a tight stomach in third trimester pregnant women are the result of false contractions, fetal movement in the womb, and also because of digestive disorders. The case study method uses a descriptive method. The case study was carried out at BPM Ernyadi Krian Sidoarjo which began on December 20, 2019. Midwifery care was carried out through assessment and evaluation. Midwifery care carried out by the author went smoothly and without any complications. In the results obtained from data collection, there is no gap between reality and theory.

Effects of raised temperature on viviparous reproduction in the marine isopod Cirolana harfordi

Temperature increases can often speed up embryonic development and shorten gestation times in viviparous and ectothermic vertebrates. Viviparity is rare among invertebrates, however, and it is unclear what effects modest rises in temperature have on viviparous animals with exoskeletons. The intertidal marine isopod Cirolana harfordi in Australia is a species whose female members incubate their young inside their thorax and give birth to live young. This mode of reproduction contrasts the typical oviparous reproductive mode of most isopods. We investigated the impacts of increased temperature on the length of pregnancy and the number of offspring produced by C. harfordi individuals. Populations of C. harfordi were maintained at control (18 °C, to represent average environment temperature at the start of the breeding season) and two increased temperature treatments (20 °C and 22 °C). Increased temperature reduced development time to the juvenile stage and increased the number of young produced. It appears that the reproductive physiology of this viviparous invertebrate is affected by modest changes in temperature.

The effect of nutrients on telomere length of fetal DNA: findings from the Mamma & Bambino cohort

Abstract Background In the first 1,000 days of life, from conception to two years of age, a variety of exposures could shape children's health. Identifying what maternal factors early affect biological aging in children represents a major public health mission. The present study aims to assess the relationship between maternal intake of nutrients in early pregnancy and telomere length of cell-free circulating fetal DNA (cffDNA) from amniotic fluid. Methods We used data and samples from the ongoing prospective “Mamma & Bambino” study, which recruits mother-child pairs from Catania (Italy) at the first prenatal visit. Maternal nutrient intakes were assessed using a Food Frequency Questionnaire referred to one-month prior the recruitment. Relative telomere length of cffDNA was assessed by real-time polymerase chain reaction, among those women who underwent amniocentesis. Results The study included 174 mother-child pairs (mean maternal age = 35.7 years) recruited from 4th to 20th gestational week. The intakes of iron, vitamin B1, and magnesium were positively correlated with relative telomere length (p-values based on Spearman's test = 0.05). However, only the intake of magnesium was positively associated with relative telomere length (β = 0.002; SE = 0.001; p = 0.024), after applying a linear regression model which included maternal age, smoking, pregestational body mass index, and total energy intake. Magnesium deficiency was negatively associated with relative telomere length after adjusting for the same covariates (β = -0.467; SE = 0.176; p = 0.009). Conclusions To our knowledge, this is the first evidence of a relationship between maternal nutrient intake and telomere length of cffDNA. The positive effect observed for magnesium is consistent with previous studies conducted in other settings. However, further efforts are needed to translate the transgenerational effect of maternal behaviors to effective public health strategies. Key messages It is crucial to understand the early effect of maternal diet on biological aging in children. The intake of magnesium positively modulates telomere length, a promising marker of aging before birth.

Plasma progesterone secretion during gestation of the captive short-beaked echidna

This study describes the progesterone profile during pregnancy in sexually mature female captive short-beaked echidnas (Tachyglossus aculeatus aculeatus). Echidnas were monitored daily by video surveillance to confirm key reproductive behaviour. Plasma samples were collected and pouch morphology was assessed three times a week. The pouch of the female echidna only develops during gestation and it was possible to create a four-stage grading system using the most distinguishable characteristics of pouch development. Maximum pouch development was associated with declining progesterone concentrations, with the pouch closing in a drawstring-like manner at oviposition. Control of pouch development in pregnant echidnas is not yet clear but later pouch development is associated with a decrease in progesterone and pouch closure and may be under mechanical influences of the egg or young in the pouch. The length of pregnancy was 16.7 ± 0.2 days with a 15.1 ± 1.0 days luteal phase followed by an incubation period in the pouch. Eggs could be detected in utero at least 4 days before oviposition. Plasma progesterone peaked at 10.5 ± 0.9 ng/mL within 12 days of mating but then declined to basal levels within 1 day of oviposition and remained basal throughout egg incubation, confirming that progesterone is elevated throughout pregnancy and that gestation does not extend beyond the luteal phase. After the loss of an egg or pouch young, most females entered a second oestrous cycle and ovulated, suggesting echidnas are seasonally polyoestrous. The duration of the luteal phase in the echidna corresponds with that observed in other mammals.

Accuracy of gestational age estimation using fetal kidney length in normal singleton pregnancies

Background A genuine appraise of gestational age (GA) plays a really vital part within the quality of care. Any wrong assessment can lead to perinatal morbidity and mortality from iatrogenic preterm or postnatal problems. Ultrasound estimation of fetal parameters is the premise for exact assurance of GA and detection of abnormalities of the fetal development. The choice of the foremost valuable single-biometric parameters depends on the timing and reason of the estimation and is influenced by different factors, especially in the second and third trimesters in which the evaluation of GA is accomplished by measuring the biparietal diameter, head circumference, abdominal circumference (AC), and femur length (FL). In the second half of pregnancy, the first trimester (CRL) is more dependable than those indices that become nonreliable as the pregnancy proceeds. Aim The aim was to evaluate the accuracy of fetal kidney length as a single indicator in estimation of GA. Patients and methods In total, 50 pregnant women with normal uncomplicated singleton pregnancy were subjected to complete history taking, general abdominal examination, and ultrasound measuring of PBD, AC, FL, right, and left kidney length. Results No noteworthy distinction was found between right and left renal lengths. The mean kidney length correlated well with the assigned GA. Fetal kidney length is considered a solid parameter, regardless of the fetal sex or kidney position. Conclusion Fetal kidney length can be utilized as an exact parameter for estimation of GA either exclusively or in combination with biparietal diameter, AC, and FL.

Gestational losses after innovating with two embryos in a fixed-time embryo transfer program

The aim of this study was to quantify the pregnancy rate after implantation of two embryos after FTET protocols, as well as to monitor pregnancy losses until parturition, evaluating, mainly, if this strategy results in more number of animals born. Therefore, 423 multiparous recipients were selected, standardized in terms of body score, who had high-quality corpora lutea. Animals were randomly divided into two groups according to one or two embryos transferred (1 embryo = Control, n = 237; 2 embryos = Group 1, n = 186). All recipients received the same hormonal treatment, which consisted of administering, on Day 0, 2 mL of estradiol benzoate (Gonadiol, ZOETIS) + 1.9 g multidose 1st use progesterone implant (CIDR, ZOETIS); on Day 8 the implants were removed + injected 0.4 mL of estradiol cypionate (E.C.P, ZOETIS) + 1.5 mL of eCG (Novormon, ZOETIS) + 1 mL of dinoprost tromethamine (Lutalyse, ZOETIS). The animals were evaluated by ultrasonography at 30 and 60 days after embryo transfer, to diagnose the success rate and embryo losses during this period. Furthermore, information was collected on births, length of gestation, number of twin births, number of childbirth assistance and the weight of the calves. The results showed that Group 1 had better success than the Control, with higher conception rates at 30 days (68.3% vs. 53.2%, P<0.001) and at 60 days (62.9% vs. 52.3%; P<0 .05). The number of animals born was also higher for Group 1 (53.3% vs. 43.3%, P<0.01). The percentage of twins born in Group 1 was 17.9%, and the animals had lower weight compared to the Control (34.29 + 7.36 vs 37.63 + 5.73, P<0.05). The length of pregnancy and the number of assistances were similar between groups. In conclusion, the strategy adopted in this experiment suggests a considerable increase in the calf birth rate, but losses during pregnancy and their mechanisms need to be elucidated.

Association between maternal urinary selenium during pregnancy and newborn telomere length: results from a birth cohort study.

Newborn telomere length is considered as an effective predictor of lifespan and health outcomes in later life. Selenium is an essential trace element for human health, and its antioxidation is of great significance for the prevention of telomere erosion. We recruited 746 mother-newborn pairs in Wuhan Children's Hospital between 2013 and 2015. Urine samples were repeatedly collected at three time points during pregnancy, and umbilical cord blood samples were collected right after parturition. Urinary selenium concentration was detected using inductively coupled plasma mass spectrometry, and newborn telomere length was measured using quantitative real-time polymerase chain reaction. We applied general estimating equations to examine the trimester-specific association between maternal urinary selenium during pregnancy and newborn telomere length. The median of creatinine-corrected selenium concentrations during pregnancy were 16.29, 18.08, and 18.35 μg/g·creatinine in the first, second, and third trimesters, respectively. Selenium concentrations in all the three trimesters were significantly associated with newborn telomere length. Per doubling of maternal urinary selenium concentrations was associated with 6.44% (95% CI: 0.92, 12.25), 6.54% (95% CI: 0.17, 13.31), and 6.02% (95% CI: 0.29, 12.09) longer newborn telomere length in the first, second, and third trimesters, respectively, after adjusting for potential confounders. This is the first study to provide evidence for the effect of maternal selenium levels on fetal telomere erosion. Findings from our study suggested that maternal urinary selenium was positively associated with newborn telomere length, indicating that intrauterine selenium exposure might have effect on initial setting of human telomere length.

Abstract 28: Omeprazole Administration To Women With Preterm Preeclampsia: Effects On Circulating Soluble Fms-like Tyrosine Kinase-1, Placental Growth Factor And Endothelin-1 Secretion.

Low soluble Fms-like tyrosine kinase (sFlt-1) has been reported in women with suspected or confirmed preeclampsia (PE) coincidentally using proton pump inhibitors (PPIs), suggesting a role for these agents as potential treatment for PE. Here, we examined whether administration of omeprazole to women with PE could acutely reduce their circulating levels of sFlt-1 or enhance their placental growth factor (PlGF) concentrations. We performed a randomized controlled trial in which women (≥ 18 years) with confirmed preeclampsia and a gestational age between 20 +0 and 34 +6 weeks were allocated to receive 40mg omeprazole once daily or no omeprazole. Blood was collected at baseline and days 1,2,4,8 followed by twice-weekly until delivery. Primary outcome was specified as the difference in sFlt-1 or PlGF 4 days after omeprazole initiation compared to the non-omeprazole group. Secondary outcomes were defined as between-group differences in longitudinal course of sFlt-1 and PlGF and pregnancy outcomes. Between Dec 2018 and June 2021, 50 women with PE were randomized, of which 40 women remained pregnant after 4 days. Mean maternal age was 30 years, and median gestational age was 31 weeks. Baseline sFlt-1 levels did not differ between non-omeprazole (n=20) and omeprazole group (n=20) (10743 vs. 7110pg/mL, p=0.11), neither did the levels of PlGF (p=0.14). After 4 days, sFlt-1 levels remained similar in women receiving omeprazole compared to women not receiving omeprazole (8364 vs. 13017pg/mL, p=0.14), and the same was true for PlGF (90 vs. 55pg/mL, p=0.14). Using linear mixed models, no difference in longitudinal course of sFlt-1 or PlGF could be attributed to the treatment group, when adjusted for baseline values and GA at enrollment (p=0.47). Women receiving omeprazole had a similar length of pregnancy compared with those not receiving this drug (median 15 vs. 14 days, p=0.70). Except for a higher neonatal intubation rate in the non-omeprazole group (31% vs 4%, p=0.02) there were no differences in maternal/perinatal complications between the two groups. Our findings suggest that daily administration of 40mg in women with PE do not alter their circulating levels of sFlt-1 and PlGF, arguing against a role for this drug as a potential treatment for this syndrome.

Does amniotic fluid sludge result in preterm labor in pregnancies after assisted reproduction technology? A nested Case - Control study

Objective to investigate the relationship between the Amniotic fluid Sludge exposure during pregnancy and the Preterm Labor (PTL) in pregnant women who had undergone Assisted Reproductive Technology procedures (ART) in Royan institute. Materials and methods It was a nested case–control study that was conducted on 110 eligible pregnant women who had undergone IVF procedure in Royan institute, Tehran, Iran. The final sample size was 63 subjects with Amniotic fluid Sludge and 67 subjects with normal Amniotic fluid. Delivery before 37 of gestation was considered as PTL. The study was approved by the ethics committee of the Royan institute and the written consent form was filled by participants. Data was entered to the SPSS (version 21, SPSS, Inc.). The baseline characteristics of the participants were described as absolute (n) and relative (%) frequencies for the covariates. Man Whitney and T-Test were used to compare the mean of covariates and the P-value lower than 0.05 was considered significant. The prevalence of the PTL was compared between two groups. Results The mean Gestational Age at delivery in case and control group were 36.46 ± 3.45 and 38.03 ± 1.61, respectively which was significant (p = .01). The prevalence of PTL in case and control group were 23.8% and 10.4% respectively which was significant (p = .04). The percentage of cases with cervical length less than 30 (mm) in case and control group were 28.6% and 10.4%, respectively (p = .008) and the percentage of cerclage in case and control group were 33.3% and 7.5% respectively, (p = .00) which were significant statistically. Conclusion The amniotic fluid sludge has a direct effect on the cervical length of pregnancies after ART. In such cases, PTB will be probable in the presence of sludge in spite of preventive treatments such as cerclage.

English

In Tanzania, the estimated delivery date (EDD) is mainly determined by the last menstrual period (LMP), presumably leading to inaccurate estimates with a falsely high proportion of post-term and preterm deliveries. The study aimed to compare EDD determination by LMP and ultrasound in pregnant Tanzanian women and examine how the dating method affects the proportions born preterm, at term, and post-term and assess how maternal characteristics relate to wrongly EDD determination by LMP. 1123 women attending antenatal care in Moshi, Tanzania were included. Gestational age (GA) at birth was calculated according to LMP and ultrasound separately. The distribution of preterm (GA<259 days), term (GA 259-294 days), and post-term (GA >294 days) births was examined separately for LMP and ultrasound. According to LMP, 17.0% of deliveries were preterm and 17.6% post-term. According to ultrasound, 7.7% of deliveries were preterm and 3.4% post-term. Unplanned pregnancy was associated with an increased odds ratio of 3.06 (95% CI: 1.91-4.91) for preterm delivery when LMP was used for EDD determination instead of ultrasound. Parity 3+ was associated with an increased odds ratio of 2.12 (95%CI: 1.16-3.89) for post-term delivery when EDD was assessed by LMP.  LMP based EDD increased the preterm birth rate two times and the post-term birth rate five times compared to ultrasound-based EDD.  Key words: Gestational age, pregnancy length, last menstrual period (LMP), dating methods, preterm, post term, Africa.

BIRTH WEIGHT AND BIRTH LENGTH AFFECTING STUNTING INCIDENT IN TODDLER

AbstractBackground: East Java is one of the regions in Indonesia that has received more attention regarding stunting because the incidence has around 36%. Stunting is a phenomenon of malnutrition that occurs in children where there are growing problems related to the length or height of the child. The history of choric energy deficiency in the mother during pregnancy, birth weight, and birth length is closely related to the incidence of stunting. The incidence of stunting at the Puskesmas Tambak Wedi Surabaya in 2018 was 18.9%. This data has increased from 2017 to 2.7%. Therefore, this study aims to determine the relationship between birth weight and birth length with the incidence of stunting under five at Puskesmas Tambak Wedi Surabaya. Methods: This study used observational analytic with a cross-sectional approach. The sample used was 30 toddlers with a simple random sampling technique. Stunting in toddlers is included in the dependent variable, while birth weight and birth length are included in the independent variables. Spearman's test was used to analyze the data in this study. Results: This study shows that there is a relationship between birth weight and the incidence of stunting in children under five who obtained a correlation coefficient value of 0.450 with a p-value of 0.012 with sufficient strength and there was a relationship between birth length and the incidence of stunting under-five children who obtained a correlation coefficient value of 0.463 with a p-value of 0.010 with sufficient relationship strength. Conclusion: Birth weight and birth length are associated with the incidence of stunting under five. Mothers need to follow the advice of health workers in maintaining nutrition during preconception, antenatal, natal, and post-natal periods with the help of the husband and family.

Reproductive Performance Of Bali Cattle Cross Breed Brahman Cattle Through Improving the Genetic Quality of Local Livestock in Special Effort for Cows to be Pregnant Program

One of the problems that exist in the community is the lack of identification of the reproductive performance of prospective brooders of Bali cattle that are artificially inseminated. The researcher conducted a research to determine the reproductive performance of Bali Cattle inseminated with Brahman Cattle Semen in SECP (Special Effort for Cows to be Pregnant Program) Program in Kolaka Regency. The parameters observed in this study were; artificial insemination's first age (Years), How many times the artificial insemination (AI) was pregnant (S/C), Length of pregnancy (months), Calving Interval (CI) (months), Birth weight (Kilograms), Correlation of AI's first age with birth weight. Sources of date used in this study are primary and secondary data. Data collection techniques carried out in this study were observation and interviews. The date obtained was analyzed descriptively, analysis of variance, average, and to calculate the relationship between variables was analyzed by correlation. Reproductive performance of Bali Cattle inseminated with Brahman Cattle Semen in SECP Program in Kolaka district include; first age AI 23.63±1.99 months, Service per Conception (S/C) 1.56±0.55, gestational age 9.03±0.38 months, Calving Interval (CI) 12.24±0 .52 months, birth weight 27.85 ± 2.96 and the correlation between AI prime age and birth spacing was 0.77.

Reproductive Performance Of Bali Cattle Cross Breed Brahman Cattle Through Improving The Genetic Quality Of Local Livestock In Special Effort for Cows to be Pregnant Program

One of the problems that exist in the community is the lack of identification of the reproductive performance of prospective brooders of Bali cattle that are artificially inseminated. The researcher conducted a research to determine the reproductive performance of Bali Cattle inseminated with Brahman Cattle Semen in SECP (Special Effort for Cows to be Pregnant Program) Program in Kolaka Regency. The parameters observed in this study were; artificial insemination's first age (Years), How many times the artificial insemination (AI) was pregnant (S/C), Length of pregnancy (months), Calving Interval (CI) (months), Birth weight (Kilograms), Correlation of AI's first age with birth weight. Sources of date used in this study are primary and secondary data. Data collection techniques carried out in this study were observation and interviews. The date obtained was analyzed descriptively, analysis of variance, average, and to calculate the relationship between variables was analyzed by correlation. Reproductive performance of Bali Cattle inseminated with Brahman Cattle Semen in SECP Program in Kolaka district include; first age AI 23.63±1.99 months, Service per Conception (S/C) 1.56±0.55, gestational age 9.03±0.38 months, Calving Interval (CI) 12.24±0 .52 months, birth weight 27.85 ± 2.96 and the correlation between AI prime age and birth spacing was 0.77.

Reproductive Performance Of Bali Cattle Cross Breed Brahman Cattle Through Improving The Genetic Quality Of Local Livestock In Special Effort for Cows to be Pregnant Program

One of the problems that exist in the community is the lack of identification of the reproductive performance of prospective brooders of Bali cattle that are artificially inseminated. The researcher conducted a research to determine the reproductive performance of Bali Cattle inseminated with Brahman Cattle Semen in SECP (Special Effort for Cows to be Pregnant Program) Program in Kolaka Regency. The parameters observed in this study were; artificial insemination's first age (Years), How many times the artificial insemination (AI) was pregnant (S/C), Length of pregnancy (months), Calving Interval (CI) (months), Birth weight (Kilograms), Correlation of AI's first age with birth weight. Sources of date used in this study are primary and secondary data. Data collection techniques carried out in this study were observation and interviews. The date obtained was analyzed descriptively, analysis of variance, average, and to calculate the relationship between variables was analyzed by correlation. Reproductive performance of Bali Cattle inseminated with Brahman Cattle Semen in SECP Program in Kolaka district include; first age AI 23.63±1.99 months, Service per Conception (S/C) 1.56±0.55, gestational age 9.03±0.38 months, Calving Interval (CI) 12.24±0 .52 months, birth weight 27.85 ± 2.96 and the correlation between AI prime age and birth spacing was 0.77.

Length of estradiol exposure >100 pg/ml in the follicular phase affects pregnancy outcomes in natural frozen embryo transfer cycles.

Do the length of follicular phase estradiol exposure and the total length of the follicular phase affect pregnancy and live birth outcomes in natural frozen embryo transfer (FET) cycles? An estradiol level >100 pg/ml for ≤4 days including the LH surge day is associated with worse pregnancy and live birth outcomes; however, the total length of the follicular phase is not associated with pregnancy and live birth outcomes. An estradiol level that increases above 100 pg/ml and continues to increase is indicative of the selection and development of a dominant follicle. In programmed FET cycles, a limited duration of follicular phase estradiol of <9 days results in worse pregnancy rates, but a prolonged exposure to follicular phase estradiol for up to 4 weeks does not affect pregnancy outcomes. It is unknown how follicular phase characteristics affect pregnancy outcomes in natural FET cycles. This retrospective cohort study included infertile patients in an academic hospital setting who underwent their first natural frozen autologous Day-5 embryo transfer cycle in our IVF clinic between 01 January 2013 and 31 December 2018. Donor oocyte and gestational carrier cycles were excluded. The primary outcomes of this study were pregnancy and live birth rates. Patients were stratified into two groups based on the cohorts' median number of days from the estradiol level of >100 pg/ml before the LH surge: Group 1 (≤4 days; n = 1052 patients) and Group 2 (>4 days; n = 839 patients). Additionally, patients were stratified into two groups based on the cohorts' median cycle day of LH surge: Group 1 (follicular length ≤15 days; n = 1287 patients) and Group 2 (follicular length >15 days; n = 1071 patients). A subgroup analysis of preimplantation genetic testing for aneuploidies (PGT-A) embryo transfer cycles was performed. Logistic regression analysis, adjusted a priori for patient age, number of embryos transferred, and use of PGT-A, was used to estimate the odds ratio (OR) with a 95% CI. In the length of elevated estradiol analysis, the pregnancy rate per embryo transfer was statistically significantly lower in patients with an elevated estradiol to surge of ≤4 days (65.6%) compared to patients with an elevated estradiol to surge of >4 days (70.9%; OR 1.30 (95% CI 1.06-1.58)). The live birth rate per embryo transfer was also statistically significantly lower in patients with an elevated estradiol to surge of ≤4 days (46.6%) compared to patients with an elevated estradiol to surge of >4 days (52.0%; OR 1.23 (95% CI 1.02-1.48)). In the follicular phase length analysis, the pregnancy rate per embryo transfer was similar between patients with a follicular length of ≤15 days (65.4%) and patients with a follicular length of >15 days (69.0%; OR 1.12 (95% CI 0.94-1.33)): the live birth rate was also similar between groups (45.5% vs 51.5%, respectively; OR 1.14 (95% CI 0.97-1.35)). In all analyses, once a pregnancy was achieved, the length of the follicular phase or the length of elevated oestradiol >100 pg/ml no longer affected the pregnancy outcomes. The retrospective design of this study is subject to possible selection bias in regard to which patients at our clinic were recommended to undergo a natural FET compared to a fresh embryo transfer or programmed FET. To decrease the heterogeneity of our study population, we only included patients who had blastocyst embryo transfers; therefore, it is unknown whether similar results would be observed in patients with cleavage-stage embryo transfers. The retrospective nature of the study design did not allow randomized to a specific ovarian stimulation or ovulation trigger protocol. However, all patients were managed with the standardized protocols at a single center, which strengthens the external validity of our results when compared to a study that only evaluates one specific stimulation protocol. Our observations provide cycle-level characteristics that can be applied during a natural FET cycle to help optimize embryo transfer success rates. Physicians should consider the parameter of number of days that oestradiol is >100 pg/ml prior to the LH surge when determining whether to proceed with embryo transfer in a natural cycle. This cycle-specific characteristic may also help to provide an explanation for some failed transfer cycles. Importantly, our findings should not be used to determine whether to recommend a natural or a programmed FET cycle for a patient, but rather, to identify natural FET cycles that are not optimal to proceed with embryo transfer. No financial support, funding, or services were obtained for this study. The authors do not report any potential conflicts of interest. N/A.

Continuous glucose monitoring in obese pregnant women with no hyperglycemia on glucose tolerance test.

The objective of the present study was to compare 24-hour glycemic levels between obese pregnant women with normal glucose tolerance and non-obese pregnant women. In the present observational, longitudinal study, continuous glucose monitoring was performed in obese pregnant women with normal oral glucose tolerance test with 75 g of glucose between the 24th and the 28th gestational weeks. The control group (CG) consisted of pregnant women with normal weight who were selected by matching the maternal age and parity with the same characteristics of the obese group (OG). Glucose measurements were obtained during 72 hours. Both the groups were balanced in terms of baseline characteristics (age: 33.5 [28.7-36.0] vs. 32.0 [26.0-34.5] years, p = 0.5 and length of pregnancy: 25.0 [24.0-25.0] vs. 25.5 [24.0-28.0] weeks, p = 0.6 in the CG and in the OG, respectively). Pre-breakfast glycemic levels were 77.77 ± 10.55 mg/dL in the CG and 82.02 ± 11.06 mg/dL in the OG (p<0.01). Glycemic levels at 2 hours after breakfast were 87.31 ± 13.10 mg/dL in the CG and 93.48 ± 18.74 mg/dL in the OG (p<0.001). Daytime blood glucose levels were 87.6 ± 15.4 vs. 93.1 ± 18.3 mg/dL (p<0.001) and nighttime blood glucose levels were 79.3 ± 15.8 vs. 84.7 ± 16.3 mg/dL (p<0.001) in the CG and in the OG, respectively. The 24-hour, daytime, and nighttime values of the area under the curve were higher in the OG when compared with the CG (85.1 ± 0.16 vs. 87.9 ± 0.12, 65.6 ± 0.14 vs. 67.5 ± 0.10, 19.5 ± 0.07 vs. 20.4 ± 0.05, respectively; p<0.001). The results of the present study showed that obesity in pregnancy was associated with higher glycemic levels even in the presence of normal findings on glucose tolerance test.

Histopathological examination of the curettage material in nonviable pregnancies and evaluation of the frequency of hydatidiform mole.

The study aimed to determine the frequency of possible missed diagnosis of gestational trophoblastic disease in nonviable pregnancies and to evaluate the importance of histopathological examination. In this retrospective study, the results of the histopathological assessment of patients undergoing uterine surgery with a diagnosis of nonviable pregnancy were analyzed before 14 weeks of gestation. Nonviable pregnancy was defined as anembryonic pregnancy and intrauterine exitus (IU-ex) based on ultrasound findings. The frequency and sonographic characteristics of molar pregnancy in nonviable pregnancy were analyzed. Molar pregnancy was detected in 24 (1.62%) of 1481 patients diagnosed with nonviable pregnancy on ultrasound. One thousand one hundred and twenty-one of the cases were IU-ex (75.69%) and the remaining were anembryonic pregnancy (24.31%). The mean crown-rump length of pregnancies in the IU-ex group was 16.7 mm and the mean gestational age was 8 weeks. The average gestational sac diameter was found to be 26 mm in anembryonic pregnancy patients. The hydatidiform mole ratio was significantly higher in anembryonic pregnancy patients (3.06%) than in IU-ex patients (1.16%) (p=0.013). The appearance of early molar pregnancy on ultrasound evaluation may mimic anembryonic pregnancies. Therefore, histopathological examination of anembryonic pregnancies may be useful in early diagnosis and for the treatment of gestational trophoblastic neoplasia.