Maternity Hospital Research Articles

Association of different types of abortions with neonatal outcomes in subsequent pregnancy.

Abortion is an important issue that concerns all women. It holds great significance to investigate the correlation between various types of abortion histories and the neonatal outcomes of subsequent pregnancies. This retrospective cohort study included pregnant women who gave birth to singleton live-born in Shanghai First Maternity and Infant Hospital from 2016 to 2020 (n = 75 773). Women with a history of abortion, including spontaneous abortion (SAB) and induced abortion (IA), were included in the exposed group, and the remaining were included in the unexposed group. The main outcomes were birthweight and preterm birth in the subsequent pregnancy. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for the association of maternal abortion history with birthweight and risk of preterm birth in subsequent pregnancy. Women who have experienced SAB history had an increased risk of delivering very low birth weight (VLBW) and preterm birth children, with (OR = 1.63, 95% CI = 1.15-2.32; OR = 1.38, 95% CI = 1.07-1.79). However, women with a history of IA were at greater risk of macrosomia (OR = 1.16; 95% CI = 1.06-1.27). We also observed that the likelihood of delivering a VLBW baby was heightened by the number of SAB occurrences (OR = 0.87, 95% CI = 0.54-1.38; OR = 1.84, 95% CI = 1.01-3.36, OR = 5.71, 95% CI = 3.21-10.15). Our study indicates that pregnant women with a history of SAB are at an increased risk of delivering VLBW infants and experiencing preterm labour. The risk is positively associated with the number of SABs. Conversely, women with a history of IA are more likely to deliver macrosomic infants.

Analyzing the Impact of Marketing Mix and Hospital Brand Image on Patient Satisfaction and Loyalty: A Study at XYZ Maternity Hospital

This study examines the impact of the marketing mix and hospital brand image on patient satisfaction and loyalty at XYZ Maternity Hospital. As healthcare services face increasing competition, especially among hospitals, marketing strategies such as the 7P marketing mix and brand image play a crucial role in enhancing patient satisfaction and building loyalty. The study uses a quantitative method with 205 postpartum patients as respondents. Data analysis using PLS-SEM reveals that both the marketing mix and hospital brand image have a significant positive effect on patient satisfaction, which in turn strongly influences patient loyalty. These findings underscore the importance of focusing on improving patient-centered services and maintaining a positive hospital image to foster long-term patient loyalty.

Predicting Admission to Neonatal Care Unit at Mid-Pregnancy and Delivery Using Data from a General Obstetric Population.

Development and validation of risk prediction models at mid-pregnancy and delivery to predict admission to the neonatal care unit. We used data from all singleton deliveries at Cork University Maternity Hospital (CUMH), Ireland during 2019. Admission to the neonatal care unit was assumed if length of stay in the unit was > 24h. Multivariable logistic regression with backward stepwise selection was used to develop the models. Discrimination was assessed using the ROC curve C-statistic, and internal validation was assessed using bootstrapping techniques. We conducted temporal external validation using data from all singleton deliveries at CUMH during 2020. Out of 6,077 women, 5,809 (95.6%) with complete data were included in the analyses. A total of 612 infants (10.54%) were admitted to the neonatal care unit for > 24 hours. Six variables were informative at mid-pregnancy: male infants, maternal smoking, advancing maternal age, maternal overweight/obesity, nulliparity and history of gestational diabetes (C-statistic: 0.600, 95% CI: 0.567, 0.614). Seven variables were informative at delivery: male infants, nulliparity, public antenatal care, gestational age < 39 weeks', non-spontaneous vaginal delivery, premature rupture of membranes and time of birth between 17:01-07.59h (C-statistic: 0.738, 95% CI: 0.715, 0.760). Using these predictors, we developed nomograms to calculate individualised risk of neonatal care unit admission. Bootstrapping indicated good internal performance and external validation suggested good reproducibility. Our nomograms allow the user to quickly estimate individualised risk of neonatal care unit admission. Future research should aim to improve accuracy in early pregnancy to better assist counselling of parents.

Reconstruction of the choana in a teenager with congenital unilateral choanal atresia after multiple choanal surgery. Case report

Choanal atresia (CA) is a congenital pathology, the frequency of which currently stands at 1 in 8000 newborns. The cause of congenital choanal atresia has not been definitively established at the moment. Diagnosis of CA often is made by pediatricians or neonatologists in the ICU oh the maternity hospital. In case of bilateral CA diagnosis is often not difficult and the diagnosis is often suggested right after labor due to asphyxia, but with a unilateral process, children can live for years without nasal obstruction in case of compensated nasal breathing. Today approaches to CA repair in children remain controversial. And if, in a bilateral process, surgical intervention is recommended to be done as early as possible, in case of the correction of the unilateral process may be postponed until older age. There is also no clear opinion on the approaches to surgical approaches, the use of protectors, the duration of their installation and the type of protector used is also controversial. The article describes a clinical case of adolescent with bilateral CA with multiple choanoplasty surgeries and restenosis. The child was admitted to Otorhinolaryngology Department of the Veltischev Research and Clinical Institute of Pediatrics and Children surgery. Despite the diagnosis that was made on time, the patient managed to improve nasal breathing only by the age of 15 after choanal reconstruction.

An Integral Assessment of Patient’s Condition in Postpartum Women with Critic Obstetric Complications

Introduction. Septic complications after critical obstetric conditions (COC) are a pressing problem in obstetrics. The aim of the study is to conduct an integral assessment of the severity of postpartum women with septic complications after COC.Materials and methods. We examined 39 postpartum women after COC (massive obstetric hemorrhage, severe preeclampsia). All patients were divided into 2 groups: the main group (n = 18) — with associated septic complications, the comparison group (n = 21) — without septic complications. The average age of the subjects was (29.80±6.48) years.Results. Obstetric bleeding was complicated by hemorrhagic shock in more than 75 % of patients in both groups. Premature detachment of a normally located placenta (PDNLP) was statistically significantly more often recorded in the main group (p = 0.04). All patients underwent total hysterectomy during childbirth or in the early postpartum period. Multiple organ failure syndrome (MODS) occurred in all women of the main group and in 17/21 (80.95 %) in the comparison group (p = 0.05). When assessing the condition of maternity hospitals using integral scales, a higher number of points were noted in the main group on the APACHE II scale (p = 0.02), SOFA (p = 0.001), NEWS2 (p &lt; 0.001). In the main group, septic complications developed on the 9 [4; 9] day after delivery.Conclusion. Risk factors for septic complications after COC are: MODS, renal failure, acute kidney injury, heart failure, respiratory distress syndrome, pneumonia. Maternity hospitals at risk of septic complications after COC initially show an increase in the number of points according to APACHE II, SOFA, NEWS2.

Comparison of efficacy of long follicular phase regimen and antagonist regimen on pregnancy outcome of fresh cycle or freeze-thawed cycle embryo transfer

Objective: To compare the pregnancy outcome of the fresh cycle or freeze-thaw cycle embryo transfer of patients treated with a long follicular phase regimen and antagonist regimen, and explore the clinical therapeutic effect of the two regimens. Methods: This was a retrospective study. The data of a total of 543 patients who underwent in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) or frozen-thawed embryo transfer (FET) in Baoding Maternal and Child Health Care Hospital from January 2020 to December 2022 were retrospectively analyzed in this study and were divided into four group to analyze the basic conditions, medication, laboratory indicators and clinical outcomes after embryo transfer of patients in each group. Results: The pregnancy rate and implantation rate in Groups A, B and C were higher than those in Group-D, and the differences were statistically significant (p&lt;0.05). The difference in multiple pregnancy rate and abortion rate among groups was not statistically significant (p&gt;0.05). The influencing factors of clinical pregnancy rate were identified by binary Logistic regression analysis. Advanced age was found to be a risk factor for improving the pregnancy rate, while the increase in the number of oocytes retrieved is a protective factor for improving the pregnancy rate. The differences were statistically significant (p&lt;0.05). Conclusion: The antagonist regimen has a low dosage and short medication time and can achieve a high embryo utilization rate and blastula formation rate, saving time and cost for patients. doi: https://doi.org/10.12669/pjms.40.10.9050 How to cite this: Li P, Zhai J, Liu T, Guo M, Wang Y. Comparison of efficacy of long follicular phase regimen and antagonist regimen on pregnancy outcome of fresh cycle or freeze-thawed cycle embryo transfer. Pak J Med Sci. 2024;40(10):2170-2175. doi: https://doi.org/10.12669/pjms.40.10.9050 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Effects of Mozart–Orff parent–child music therapy among mothers and their preschool children with autism spectrum disorder: A mixed-methods randomised controlled trial

BackgroundAutism spectrum disorder (ASD) negatively impacts mental health, particularly in mothers of autistic children who experience heightened stress. Applied behaviour analysis (ABA) and music therapy are recognised interventions for improving ASD symptoms. However, the specific benefits of parent–child music therapy and ABA for autistic children and their mothers remain uncertain. This study evaluated the effects of parent–child music therapy on preschool autistic children and their mothers.MethodA randomised controlled trial was conducted with 100 mother–child pairs assigned to either the control group receiving ABA or the intervention group receiving both music therapy and ABA. Qualitative interviews were conducted post-intervention for 12 mothers.ResultsChildren in the intervention group exhibited lower scores for ASD symptoms than those in the control group. Moreover, mothers in the intervention group demonstrated reduced dysfunctional parent–child interaction, lower overall parental stress, significantly improved family functioning, and increased levels of hope compared with those in the control group. Mothers held positive views regarding music therapy.ConclusionsCombining ABA with parent–child music therapy can alleviate ASD symptoms in children and reduce stress in mothers. Improved parent–child interaction and enhanced family functioning further support the benefits of this combined approach. Parent–child music therapy, combined with ABA demonstrated positive outcomes for autistic children, including reduced ASD symptoms, improved parent–child interaction, decreased parental stress, enhanced family functioning, and increased hope. These findings highlight the potential of incorporating music therapy as a valuable component in the comprehensive treatment of ASD.Trial registrationThis study was registered in the Chinese Clinical Trial registry (05/07/2021, ChiCTR2100048261, https://www.chictr.org.cn/showproj.html?proj=128957). Ethical approval was obtained from the Research Ethics Committee of Fujian Medical University and the study hospital (Fujian Provincial Maternity and Child Health Hospital; 2017 − 105), and informed consent was obtained from all subjects and/or their legal guardian(s).

Hidradenitis Suppurativa and Maternal and Offspring Outcomes

Hidradenitis suppurativa (HS) is associated with morbidity in persons of reproductive age, but the effect on maternal and offspring outcomes is understudied. To determine the association of HS with pregnancy outcomes and maternal and child morbidity in the long term. This population-based longitudinal cohort study with up to 16 years of follow-up took place between 2006 and 2022 in Quebec, Canada. . Maternal HS. Outcomes included hypertensive disorders of pregnancy, gestational diabetes, and other birth outcomes as well as the long-term risk of hospitalization up to 16 years after delivery. The study used adjusted log-binomial and Cox proportional hazards regression models to estimate the association between maternal HS and pregnancy outcomes or hospitalization following pregnancy. Outcomes in both mothers and offspring were assessed. There were 1 324 488 deliveries during the study, including 1332 (0.1%) among mothers with HS. Compared with patients without HS, patients with HS had a greater risk of hypertensive disorders of pregnancy (risk ratio [RR], 1.55 [95% CI, 1.29-1.87]), gestational diabetes (RR, 1.61 [95% CI, 1.40-1.85]), and severe maternal morbidity (RR, 1.38 [95% CI, 1.03-1.84]). In neonates, maternal HS was associated with risk of preterm birth (RR, 1.28 [95% CI, 1.07-1.53]) and birth defects (RR, 1.29 [95% CI, 1.07-1.56]). In the long term, HS was associated with 2.29 times the risk of maternal hospitalization (95% CI, 2.07-2.55) and 1.31 times the risk of childhood hospitalization (95% CI, 1.18-1.45), including hospitalization for respiratory, metabolic, psychiatric, and immune-related morbidity over time. This cohort study found that HS is associated with adverse maternal and offspring outcomes in the peripartum period and in the long term. Early detection and management of HS may help mitigate these outcomes.

Assessment of severity and avoidability of adverse drug reactions in neonates: a reproducibility study of the Hartwig tool and LAAT.

Tools for classifying adverse drug reactions (ADRs) have not yet been validated in the context of the neonatal intensive care unit (NICU). The study aims to investigate the inter-rater reliability of the Hartwig tool and the Liverpool avoidability assessment tool (LAAT) in assessing the severity and avoidability of ADR cases in hospitalized neonates. An observational and prospective study was conducted in the NICU of a maternity hospital in Natal, Brazil. The Hartwig tool and LAAT were employed to assess the severity and avoidability of ADRs, respectively. Three experienced clinical pharmacists independently assessed all ADR cases. Inter-rater reliability was measured using Cohen's kappa coefficient (k) with corresponding 95% confidence intervals (CI). Among 79 ADR cases, the mean gestational age was 29.7 ± 4.4weeks, and the birth weight averaged 1446.0 ± 1179.3g. The assessment of ADR severity using the Hartwig tool revealed a significant overall correlation (overall k = 0.573; 95% CI 0.395 to 0.753) with exact agreement (EA) and extreme disagreement (ED) rates between evaluators of 86.5% and 2.5%, respectively. However, no statistically significant correlation was observed for determining avoidability using the LAAT (overall k = 0.017; 95% CI - 0.048 to 0.082), with an EA rate of 83.6% and ED rate of 10.1%. The Hartwig tool demonstrates good reproducibility among different evaluators in determining the severity of ADRs, unlike the LAAT for assessing avoidability.

Congenital Heart Defects as One of the Causes of Perinatal Mortality

Congenital malformations are one of the most common causes of infant mortality and disability in children, and congenital heart defects (CHD) occupy a leading place in the structure of all developmental anomalies. The article presents data from a retrospective analysis of charts of children who died from complex congenital heart defects and congenital heart defects in combination with multiple developmental defects. An analysis of the pathological examination cards of 102 children from 0 to 2 years old who died in maternity hospitals and children's hospitals in Bishkek was carried out. The selection of autopsy cards of children was carried out on the basis of the Republican Pathological Bureau. As a result of pathological studies, changes in the heart and lungs were revealed. At the maternity hospital stage, out of 102 children with severe congenital heart defects, 70 newborns died, which averaged 68.6%. Among congenital heart defects, heart defects with aortopulmonary shunting with pulmonary hypertension predominated — in 45 children (44%), in particular, ventricular septal defect, atrial septal defect, then ductus-dependent heart defects were diagnosed in 25 children (24.5%), which included Tetralogy of Fallot, transposition of the great vessels. 23.5% of children had multiple congenital malformations: in all cases, congenital heart disease was recorded in combination with several malformations, such as an anomaly of the musculoskeletal system with craniofacial dimorphism, anomalies of the gastrointestinal tract and urinary system, and an anomaly of the lungs. The most common association of congenital heart disease with defects of other organs and systems was observed in cases of ventricular septal defect, atrial septal defect, patent ductus arteriosus.

Prenatal diagnosis and postnatal follow-up of 15 fetuses with 16p13.11 microduplication syndrome

BackgroundThe clinical phenotypes of 16p13.11 microduplication syndrome have been extensively reported in previous studies, mostly about adults and children, with limited information available on fetal cases. This study aims to explore the genotype-phenotype correlation of fetuses with 16p13.11 microduplication syndrome and analyze the characteristics of prenatal diagnosis indications and provide clinical information for prenatal and postnatal genetic counseling.MethodsWe conducted a retrospective analysis of 3,451 pregnant women who underwent invasive prenatal diagnosis for SNP array between January 2018 and December 2022 at the Jinan Maternal and Child Health Hospital. Descriptive statistical analysis was performed on the prenatal diagnosis indications, pedigree analysis, pregnancy outcomes and postnatal follow-up of 15 fetuses with 16p13.11 microduplication syndrome.ResultsSNP array revealed that 15 fetuses had duplications in the 16p13.11 region with varying prenatal diagnosis indications. Among the cases, 6/15 exhibited ultrasound abnormalities, 5/15 had abnormal chromosomal copy number variations as indicated by non-invasive prenatal testing (NIPT), one case involved advanced maternal age, and 3/15 had other abnormalities. 16p13.11 microduplication syndrome was closely related to ultrasound abnormalities, especially structural abnormalities and soft marker anomalies (abnormal ultrasonic soft indicators), while the indication of NIPT could improve the detection rate of copy number variations (CNVs) in this region. Only 7/15 fetuses underwent pedigree verification, with one case of de novo 16p13.11 microduplication, and the others inherited from one parent. Pregnancy was terminated in 2/15 cases and the outcome of one case is unknown due to loss to follow-up. Among the remaining cases, only one case exhibited a ventricular septal defect, while another presented with omphalocele. No other obvious abnormalities were reported postnatally.ConclusionThe prenatal phenotypes of fetuses with 16p13.11 microduplication were highly associated with ultrasound abnormalities but lacked specificity. Comprehensive genetic tracing, outcome analysis, and follow-up are essential for providing accurate prenatal and postnatal genetic counseling.

Factors associated with breastfeeding rates at 1 month of age: Focusing on newborn feeding behaviours in a Japanese maternity hospital.

This study investigated the relationship between newborn feeding behaviour and feeding type among month-old babies and explored maternal and neonatal factors associated with breastfeeding rates at 1 month of age. This observational study was conducted in Japan with healthy mothers and full-term newborns. Newborn feeding behaviours were assessed using the Japanese Infant Breastfeeding Assessment Tool (IBFAT) within approximately 1 day of birth. Obstetric and newborn characteristics, including newborn feeding behaviours, were investigated in relation feeding type (breast milk or mixed milk) at 1 month of age. This study included 176 mother-newborn pairs. IBFAT scores were significantly higher in the breast-milk group (Median (M) = 10.5, Interquartile Ranges (IQR): 9.0-11.0) than in the mixed-milk group (M = 10.0, IQR: 7.5-11.0) (P = 0.046). Additionally, the sucking pattern of breastfeeding was showing a greater distribution of higher scores in the breast-milk group (M = 2.0, IQR: 2.0-2.5) than in the mixed-milk group (M = 2.0, IQR: 1.5-2.5) (P = 0.015). Compared to mothers who received epidural analgesia or synthetic oxytocin, primiparas who did not receive them were more likely to breastfeed (epidural analgesia: (33.3% vs. 65.8%, P = 0.004); synthetic oxytocin: (42.0% vs. 78.6%, P = 0.018)). For multiparas, Apgar and IBFAT scores were associated with feeding type at 1 month of age. This study found that newborns' effective and sustained sucking within 1 day of birth is an important factor for breastfeeding at 1 month of age. When assessing feeding type, maternal factors such as epidural analgesia should be the focus for primiparas, while neonatal factors such as feeding behaviour should be prioritised for multiparas.

Assessing the Effectiveness of Wet Mount and PCR Methods in Diagnosing Trichomonas vaginalis Infections in Endocervical and Urine samples

Trichomonas vaginalis is the cause of trichomonas’s infection, which is referred to be the global sexually transmitted disease (STD) worldwide. This parasite primarily spreads through sexual activity, though it can also spread through intimate. Vaginal inflammation in females causes a variety of clinical symptoms, such as a profusion of greenish-yellow, frothy, foul-smelling discharge, valvar enlargement, itching, and punctate erythematous lesions of the cervix, commonly referred to as "strawberry cervix." There are numerous scenarios in which women may be sick but not exhibit any symptoms. The purpose of the current study is to compare the diagnostic efficacy of polymerase chain reaction (PCR) and wet mount preparation for detecting T. vaginalis in various sample types, including endocervical discharge, endocervical swabs, and urine, of 300 female patients (married and single), ages ranging from 15 to 62, who were referred to Dohuk Maternity Hospital, Shariya Camp, either inside or outside of Dohuk city. Based on the clinical symptoms of the patients, the diagnosis of parasite infection was validated by microscopically confirming the infection in the laboratory using two methods: PCR and direct wet mount preparation. The study findings demonstrated, out of 240 samples, 61 (25.4%) at Dohuk Maternity Hospital and 15 (25%) out of 60 samples in Shariya Camp were contaminated with T. vaginalis. Of the 300 samples, 74 (24.6%) had wet mount preparation infection, and 75 (25.0%) had PCR infection. In the current study, 42 single women had 10 (23.8%) and 258 married women had 66 (25.5%) infected. The age range of 15 to 25 had a higher infection rate (32.8%).

Maternal and Fetal Outcome of COVID-19 Infection among Pregnant Women.

Background and Objectives: Pregnant women face an increased risk of experiencing negative consequences due to COVID-19 infection. Our study aimed to identify outcomes for both mothers and fetuses associated with COVID-19 during each trimester, as well as to identify post-COVID symptoms in this population. Materials and Methods: Among the total population, 14 females were infected during the first trimester, 25 during the second, and 66 during the third trimester. Weekly follow-ups were conducted until delivery. Seventy-five females (71.4%; 95% CI:26.9-115.9%) were admitted to the hospital secondary to COVID-19 infection. Maternal hospitalization was independently associated with COVID-19 severity (adjusted odds ratio (aOR) = 3.9; 95% CI: 1.6-9.2 at p = 0.002 relative to the reference group (mild infection)) and the presence of dyspnea at initial assessment (aOR = 6.9; 95% CI: 1.7-28.2 at p = 0.007 relative to nondyspneic patients). Results: The duration of hospitalization (mean ± SD) was higher in the third trimester than the first and second trimesters (10.1 ± 0.8 vs. 4.0 ± 1.2 days and 10.1 ± 0.8 vs. 6.2 ± 1.4 days, respectively, at p < 0.05). The number of maternal deaths in the third trimester was higher than in the first and second trimesters (16 (24.2%) vs. no deaths and 16 (24.2%) vs. 1 (4%) deaths, respectively, at p < 0.05). In terms of fetal outcomes, a good fetal condition was more likely if the mother was infected during the first trimester (92.9%) than the second (80%) or third trimesters (66.7%), but the difference was not significant. The percentage of preterm deliveries was insignificantly higher in the second trimester (16%) than the first (7.1%) and third (4.5%) trimesters. Conclusions: The most common post-COVID symptoms included persistent loss of smell, dry eyes, post-partum depression, knee pain, and myalgia. Post-COVID symptoms were more prevalent in patients infected during the third trimester. The adverse outcomes of COVID-19 infection for both mother and fetus were more severe in cases where the infection occurred during the third trimester compared to the second and first trimesters. Therefore, it is crucial to adhere to precautionary measures against COVID-19, prioritize vaccination, and provide comprehensive care for pregnant mothers.

POSIÇÕES NÃO-SUPINAS E AUTONOMIA MATERNA NA ASSISTÊNCIA AO PARTO POR EQUIPE DE FISIOTERAPIA EM SAÚDE DA MULHER

Introduction: Childbirth in supine positions centralizes interventions instead of maternal autonomy, physiology and biomechanics of birth which are facilitated by non-supine positions. Objective: To quantitatively describe the prevalence of maternal positioning choice and non-supine positions in childbirth through assistance conducted by a Women's health physiotherapy team. Methods: Quantitative and descriptive cross-sectional study through retrospective secondary data available on the Assistance Database of the Women's health physiotherapy service of a public maternity hospital in Salvador from 2015 to 2019. initiated after approval by the Research Ethics Committee and waiver of the informed consent form. Results: Out of the total patients assisted by a multidisciplinary team with Women’s Health physiotherapists during childbirth from 2015 to 2019, 35.1% delivered in the supine position and 61% in non-supine positions. 65.4% chose the position they give birth in and 34.3% didn’t. Conclusion: Delivery assistance by a multidisciplinary team with a physical therapist promotes deliveries in non-supine positions and maternal autonomy during childbirth.

Male Nursing Students’ Perceptions of Their Clinical Practice in Maternity Hospital at Sulaymaniyah Polytechnic University and University of Sulaymaniyah Colleges of Nursing

Background: The field of nursing remains dominated by women in many countries. Males joining the nursing and midwifery fields are becoming more numerous, and with that comes more problems during training. It is crucial to comprehend the experiences and difficulties faced by male nursing students during their nursing education, as these obstacles differ depending on the culture. Aims: The objectives of the study are to explore the perceptions of male nursing students at Sulaimani Polytechnic University and University of Sulaimani Colleges of Nursing about their clinical maternity hospital. Materials and Methods: A quantitative-descriptive design has been carried out in Sulaimani city. A non-probability, convenience sample size of (100) students was included in this study over a period of 1 month. Through an extensive review of relevant literature, a questionnaire was designed for data collection. Results: The results confirmed that male nursing students generally feel more comfortable performing procedures that do not involve exposure to private parts compared to those that do involve such exposure. The association between age groups, marital status, Residency College, and comfort level is not significant (P &gt; 0.05). While, the P = 0.045, indicating that the association between class and comfort level is significant (P &lt; 0.05). Conclusion: The study indicated that while the participants regarded the maternity clinical practice to be difficult, they did not show any interest in doing the maternity course. It was believed that male nursing students’ experiences with maternity clinical practice would be enhanced by acceptance and more specialized training in the clinical setting.

Effect of Nurse-Assisted Early Warning Intervention for Prevention of Venous Thromboembolism Following Cesarean Delivery

Abstract Objective The aim of the study is to assess the role of a nurse-assisted early warning intervention in improving prophylaxis against obstetric venous thromboembolism (VTE) and preventing VTE following cesarean delivery (CD). Methods A prospective cohort study conducted between January 1, 2020, and December 30, 2022, enrolled pregnant women who underwent CD in the obstetric unit of Women’s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital. The patients were assigned to a control group (routine nursing care) or the intervention group (nurse-assisted early warning intervention) depending on whether or not the nurse-assisted early warning intervention had been implemented. The χ 2 test and Student’s t test were used for statistical analysis. The primary outcome was the incidence of systemic VTE following CD, and secondary outcomes were the rates of mechanical or pharmacologic prophylaxis receipts for VTE and the frequency and severity of adverse events related to pharmacologic prophylaxis. Results A total of 27,074 cases were enrolled. The incidence of symptomatic VTE following CD was significantly lower in the intervention group (0.29 per 1000 deliveries) than in the control group (2.4 per 1000 deliveries) (P &lt; 0.001). Significantly more cases received mechanical and pharmacological VTE prophylaxis in the intervention group than in the control group (respectively, 19.8% vs. 12.6% receiving mechanical prophylaxis and 0.9% vs. 0.2% receiving pharmacological prophylaxis). No cases of life-threatening bleeding occurred in either group. Conclusion The application of nurse-assisted early warning intervention may be an effective method for preventing VTE following CD.

Genetic analysis of a child with 18q terminal deletion and aortic regurgitation and a literature review

To explore the genetic characteristics of a child with 18q terminal deletion syndrome. Clinical data of a child presented at the Lianyungang Maternal and Child Health Care Hospital on July 20, 2023 was collected. Peripheral blood sample from the child was subjected to G-banded chromosomal karyotyping and chromosomal microarray analysis (CMA). Relevant literature was searched from CNKI, WanFang and PubMed databases over the past decade (from November 1, 2013 to November 1, 2023) using keywords including "18q-syndrome", "18q deletion syndrome" and "18q terminal deletion". This study was approved by the Lianyungang Maternal and Child Health Care Hospital (Ethics No. LYG-MER2021017). The child, a 4-year-and-6-month-old female, had manifested short stature, intellectual disability, distinctive facial features, aortic regurgitation, auditory canal atresia, and white matter lesions. She was found to have a karyotype of 46,XX,del(18)(q21), whilst the result of CMA was arr[GRCh37]18q21.33q23(60065821_77317445)×1. Both of her parents were found to have a normal karyotype. Literature review has retrieved 7 reports which involved 11 cases with a terminal 18q23 deletion. The phenotypes of cardiac abnormalities have been diverse, with pulmonary stenosis, atrial septal defect and ventricular septal defect being most common. The 18q terminal deletion probably underlay the multiple congenital anomalies and mental retardation in this child.

Clinical and genetic analysis of a Chinese pedigree affected with Familial focal epilepsy with variable foci due to variant of NPRL3 gene

To explore the clinical manifestations and genetic etiology of a Chinese pedigree affected with Familial focal epilepsy with variable foci (FFEVF). A FFEVF pedigree presented at the Department of Medical Genetics of Linyi Maternal and Child Health Care Hospital on March 14, 2023 was selected as the study subject. The proband was subjected to whole exome sequencing (WES). Candidate variants were verified by Sanger sequencing of the proband and other affected members and bioinformatic analysis. This study was approved by the Linyi Maternal and Child Health Care Hospital (Ethics No. QTL-YXLL-2023048). WES revealed that the proband has harbored a heterozygous c.1642C>T (p.Arg548Cys) missense variant in exon 15 of the NPRL3 gene. Sanger sequencing confirmed that the variant was inherited from the proband's father, and multiple members of the pedigree had also harbored the same variant. Based on guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was classified as variant of unknown significance (PM2_supporting + PP3). The clinical phenotype of FFEVF patients caused by variants of NPRL3 gene is extensive, and the patients may present with neurological abnormality of autism spectrum disorder in addition to seizures.

Genetic analysis of a fetus with Coffin-Siris syndrome 2 due to a novel variant of ARID1A gene

To explore the genetic etiology of a fetus with Coffin-Siris syndrome (CSS). A fetus with abnormal ultrasound findings detected at Luoyang Maternal and Child Health Care Hospital in July 2023 was selected as the study subject. Clinical data were analyzed retrospectively. Whole exome sequencing was carried out on fetal tissue and parental peripheral blood samples, and candidate variant was verified by Sanger sequencing and pathogenicity analysis. This study was approved by the Luoyang Maternal and Child Health Care Hospital (Ethics No. LYFY-YCCZ-2023011). Color Doppler ultrasound at 16+ gestational weeks revealed bilateral ventriculomegaly and cerebellar hypoplasia in the fetus. Trio-WES found that the fetus has harbored a heterozygous c.553C>T (p.Gln185Ter) variant of the ARID1A gene, which was verified by Sanger sequencing to have a de novo origin. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the c.553C>T (p.Gln185Ter) variant of the ARID1A gene was classified as pathogenic (PVS1+PS2_Supporting+PM2_Supporting). The fetus was diagnosed with CSS type 2, and the heterozygous c.553C>T (p.Gln185Ter) variant of the ARID1A gene probably underlay its brain malformations.