To investigate risks of pregnancy and birth in patients with peripheral vascular malformations (VMs). Nationwide cross-sectional study. Tertiary referral centre and Dutch national patient organisation. Women aged ≥ 15 years diagnosed with peripheral VM of any subtype or anatomical location. Patients were invited to complete a comprehensive questionnaire about obstetric history and VM-related symptoms during pregnancy. Prevalence of complications, specifically worsening of VM-related symptoms during pregnancy, deep venous thrombosis (DVT), pulmonary embolism (PE) and postpartum haemorrhage (PPH). Two-hundred-six women completed the questionnaire. Among 108 patients, 248 pregnancies and 204 births were reported; 98 patients were nulligravid. DVT and PE occurred in 2.5% and 0.5% of total pregnancies, respectively and only occurred in patients with extensive VMs (> 30 cm) involving at least the lower extremities (predominantly Klippel-Trenaunay). PPH occurred in 19.6% of births, including in 63.6% of those with uterine involvement and 47.8% with genital involvement of the VM. VM-related symptom worsening and volume increase during pregnancy occurred in 47.6% and 45.4% of patients, respectively. In multivariable regression, AVM subtype (OR 4.0, 95% CI 1.0-15.1), genital region involvement (OR 4.6, 95% CI 1.5-13.8), and a history of puberty-related symptom progression (OR 2.6, 95% CI 1.1-6.2) were independently associated with VM-related symptom worsening during pregnancy. Women with VMs appear to have a significant risk of PPH and worsening of VM-related symptoms during pregnancy, especially if the genital region is involved. Increased thromboembolic risk appears confined to patients with extensive VMs involving the lower extremities.

Epidermal growth factor plays an important role in cervical maturation and tissue remodeling during pregnancy. This study aimed to investigate the association between maternal serum epidermal growth factor levels measured at 37 weeks of gestation and late-term delivery. This single-center case-control study was conducted at a tertiary maternity hospital. Low-risk pregnant women were enrolled, and high-risk pregnancies were excluded. Maternal blood samples were collected at 37 weeks of gestation prior to the onset of labor. Serum epidermal growth factor concentrations were measured using an enzyme-linked immunosorbent assay. Participants were classified according to the gestational age at delivery as late-term pregnancies or term controls. Demographic characteristics, obstetric outcomes, mode of delivery, neonatal outcomes, and serum epidermal growth factor levels were compared between groups. A total of 83 pregnant women were included, of whom 35 women delivered at the late term and 48 women delivered at term. The maternal age, body mass index, obstetric history, and Apgar scores did not differ significantly between groups. The gestational age at delivery and birth weight were significantly higher in the late-term group (p=0.001 and p=0.004, respectively). Cesarean delivery was more frequent among late-term pregnancies (70.8% vs 40%, p=0.005). Mean maternal serum epidermal growth factor levels were significantly lower in the late-term group compared with term controls (28.8±9.8 ng/L vs 56.7±27.3 ng/l, p=0.005). Maternal serum epidermal growth factor levels measured at 37 weeks of gestation were significantly lower in pregnancies resulting in late-term delivery. These findings suggest that altered epidermal growth factor regulation may be associated with prolonged gestation and delayed cervical maturation.

Psychiatric and obstetric outcomes among peripartum patients with bipolar disorder: A single-institution study.

After methotrexate administration to treat and ectopic pregnancy, patients follow-up for a laboratory evaluation to measure human chorionic gonadotropin (hCG) response. This follow up occurs on day 4 and 7, with day 1 being the day of methotrexate administration. With no validated alternative, patients may have difficulty adhering to this follow-up schedule. The objective of this retrospective cohort study was to compare outcomes of monitoring patients on days 4 and 7 to days 5 and 8 following methotrexate administration for confirmed or suspected ectopic pregnancies. We performed a retrospective cohort analysis within the Military Health System, identifying individuals treated with methotrexate for either confirmed or suspected ectopic pregnancy between 2016 and 2025. Cases were identified using ICD-10 diagnostic codes, followed by manual chart review to collect: demographics, obstetric history, initial hCG level, follow-up schedule, subsequent hCG levels after treatment, dose(s) of methotrexate administered, whether surgical intervention was required. Regardless of cohort, treatment response was characterized by a ≥15% decline in serum hCG between monitoring days without surgical intervention. Patients monitored on post-treatment days 5 and 8 following methotrexate were compared with those followed on days 4 and 7. Exclusion criteria included an initial hCG level greater than 5,000 mIU/mL, planned two-dose methotrexate protocols, or lost to follow-up. Treatment success was defined as a final hCG level less than 25 mIU/mL. Statistical comparisons were conducted using Fisher's exact test and Mann-Whitney U test, as appropriate. This study was deemed exempt by our institution's IRB (WRNMMC-EDO-2025-1355). We identified 136 patients, 100 patients monitored on days 4 and 7, and 36 patients monitored on days 5 and 8. There were no statistical differences in patient age at time of methotrexate administration, ethnicity/race, gravidity and parity, and history of ectopic pregnancy. Baseline methotrexate dose (4/7: 91.5 mg/m2, 5/8: 92.2 mg/m2) and initial hCG (4/7: 1350.2 mIU/mL, 5/8: 1341.1 mIU/mL) were similar between groups. The majority of patients in both cohorts had a successful response to methotrexate (4/7: 60.0%, 5/8: 63.9%). Of these responders, methotrexate without additional intervention was successful in the majority of cases (4/7: 96.7%, 5/8: 91.3%). Frequencies of treatment success were 79/83 (95.2%) in patients who did versus 45/54 (83.3%) in patients who did not have a treatment response (OR 3.95, 95% CI [1.21, 15.3]). Following up on days 5 and 8 or days 4 and 7 post-methotrexate treatment led to similar outcomes in ectopic pregnancies. These data provide reassuring evidence that the appropriately counseled patient can follow-up on day 5 and 8, rather than 4 and 7, after methotrexate administration and still be safely managed.

Caesarean section (C-section) rates are rising globally, including in Türkiye, indicating a significant shift in obstetric practices. To standardise monitoring, the World Health Organization (WHO) advocates for the Robson 10-group classification system (RTGCS), with categorises all deliveries into ten distinct groups based on obstetric history and current pregnancy characteristics, such as parity, previous C-section, and foetal presentation. This study evaluated C-section rates at a Turkish tertiary referral centre using this classification to identify targets for clinical quality improvement. This retrospective study analysed deliveries over 12 years, between 1 July 2012 and 1 October 2024, stratified based on RTGCS. Pairwise comparisons utilised independent t-tests for numerical data and Pearson's chi-squared tests for nominal variables. Statistical significance was set at p < 0.05, with results presented alongside 95% confidence intervals (CI). A total of 119,767 deliveries were evaluated. Of these, 84.5% (n = 101,252) involved Turkish nationals and 15.5% (n = 18,515) involved refugees. Overall, 56,986 deliveries (47.6%) were performed by C-section, with a higher rate among Turkish women (49.6%) compared with refugee women (36.4%). Within the four largest Robson groups, Group 5 provided the highest absolute contribution to the total C-section count at 21.0%. The absolute contributions for Groups 1, 3, and 10 were 5.9%, 5.8%, and 5.5%, respectively. Collectively, these four groups accounted for 38.2% of all deliveries and 80.2% of all C-section cases recorded in the study. This study indicated that the overall C-section rate was 47.6%, predominantly driven by Group 5, followed by Groups 10, 3, and 1.

With the changing perception of Caesarean Section (CS) from a lifesaving to a routine procedure, non-medically indicated CS is increasing. This study assessed the prevalence, indications, and preference for CS among women attending primary health care (PHC) units in Port Said Governorate, Egypt. A cross-sectional study was conducted from December 2023 to February 2024 in six primary health care units across Port-Said Governorate, Egypt. Married women of childbearing age who had experienced at least one childbirth (primiparous and multiparous) were included. A total of 179 participants were recruited using multistage sampling, combining random selection of PHC units and consecutive sampling of eligible women. Data were collected using a validated structured questionnaire covering socio-demographics, obstetric history, last delivery experience, and preference for the next delivery. Statistical analysis was performed using SPSS v26, including univariate and multivariate logistic regression to identify factors associated with CS and delivery preference. A total of 179 women participated in the study. Of these, 68% had CS for their last delivery. The most frequently reported reasons for previous CS were fear of labor (56%), prolonged labor (18%), and long distance to the hospital (15.6%). Regarding future delivery preferences, (61.5%) of women expressed a preference for CS. The leading reasons cited were less pain (81.8% ), the belief that CS is safer for the baby (57.3%), and the knowledge of the time of delivery (32.2%). Multivariate logistic regression identified independent predictors for each outcome. Women with higher income [AOR 10.0, 95% CI 2.7-36.9, < 0.001] and those whose doctor suggested CS [AOR 19.2, 95% CI 5.5-67.1, p < 0.001] were more likely to have had a CS in their last delivery. In contrast, preference for CS in the next delivery was independently associated with higher husband education [AOR 12.1, 95% CI 1.2-124.3, p = 0.036] and a history of previous CS [AOR 14.7, 95% CI 6.2-34.6, p < 0.001]. Fear of labor and previous CS were the main drivers of past and preferred future CS deliveries, with non-medical factors outweighing medical indications. Findings highlight the need for educational interventions to support informed delivery choices.

We aimed to evaluate the association between serial transvaginal cervical length measurements following McDonald cerclage and spontaneous preterm birth (PTB). This retrospective study included singleton pregnancies with cerclage performed during 2010-2024. Cerclage was placed prophylactically (n = 109) based on obstetric history, or emergently (n = 46) due to ultrasound findings. Cervical length was measured by transvaginal ultrasound before and after cerclage, and at 2-week intervals until 32weeks. For the prophylactic group, the median cervical length was shorter among those who delivered PTB < 37weeks (n = 23) than term: at 21-22 + 6weeks (2.5 vs. 3.9cm, p = 0.042), 23-24 + 6weeks (2.0 vs. 3.4cm, p = 0.016), 25-26 + 6weeks (3.0 vs. 3.8cm, p = 0.042), and 31-32 + 6weeks (2.4 vs. 3.4cm, p = 0.015). In multivariable analysis adjusted for history of PTB, progesterone use, and gestational age at cerclage placement, shorter cervical length, at 23-24 + 6weeks (adjusted odds ratio [aOR] 4.13, 95% confidence interval [CI] 1.23-13.89, p = 0.021) and at 25-26 + 6weeks (aOR 3.39, 95% CI 1.08-10.64, p = 0.037), was independently associated with PTB < 37weeks. Cervical length at 25-26 + 6weeks was associated with PTB < 32weeks (aOR 4.76, 95% CI 1.20-19.60, p = 0.027). For the emergency group, the median cervical length was shorter among those who delivered < 32weeks than later, at 23-24 + 6weeks (1.4 vs. 3.2cm, p = 0.049) and 25-26weeks (1.5 vs. 2.3cm, p = 0.041). Serial cervical length monitoring after cerclage provides a clinically relevant prediction of spontaneous PTB.

Immediate postpartum diabetes (IPD) testing on day 1 or 2 shows similar diagnostic value to testing at 4 to 12 weeks' postpartum and achieves higher completion rates. Our institution implemented IPD testing on December 1, 2023, before the American College of Obstetricians and Gynecologists' endorsement, to compare pre and postimplementation testing rates and to assess associated maternal and neonatal outcomes. We conducted a retrospective cohort study of patients with gestational diabetes mellitus (GDM) who delivered at our community-academic medical center before (September 1, 2022-November 15, 2023) and after (December 1, 2023-October 31, 2024) IPD implementation. The preimplementation group underwent outpatient testing 4 to 12 weeks' postpartum. The postimplementation group was tested in-hospital 1 or 2 days' postpartum. Both groups received a 2-h our glucose challenge test. Electronic medical records were queried for demographics, medical and obstetric history, GDM information, and postpartum diabetes testing results. Completion rates, maternal, and neonatal factors were compared across and within cohorts using chi-square tests and t-tests. Across 155 patients (63 preimplementation, 92 postimplementation), baseline characteristics were similar, excluding age. Testing completion increased nearly 5-fold postimplementation (14.3% [9/63] vs. 68.5% [63/92], p < 0.01). In the postimplementation group, 49% of tested patients had abnormal results (43% impaired glucose metabolism, 6% overt diabetes). Non-English speakers and those with a postpartum length of stay > 1 day were more likely to be tested (22.2 vs. 3.45%, p = 0.02; 98.4 vs. 48.3%, p < 0.01). Neonates in the tested group had a lower mean birth weight (3,137.1 ± 665.1 vs. 3,374.4 ± 484.7 g; p = 0.05), longer nursery stay (2.55 ± 2.2 vs. 1.83 ± 0.69 days; p = 0.03), and more neonatal intensive care unit admissions (20.63 vs. 0%; p = 0.01). IPD testing dramatically improved testing and identified a high prevalence of persistent dysglycemia immediately postpartum. Hospital systems should consider implementing this practice change to improve testing rates and early intervention in postpartum care of patients with GDM. · IPD testing is a feasible and replicable practice.. · IPD testing increased rates nearly 5-fold compared with traditional timing.. · Persistent dysglycemia was identifiable immediately postpartum.. · Longer hospital stays increased the likelihood of testing.. · In-hospital testing may reduce language barriers..

Abstract Background Enduring harmful traditional umbilical cord care practices have continued to remarkably contribute to neonatal sepsis and mortality in Nigeria, despite WHO recommendations. While knowledge of safe practices is often high, the persistence of harmful traditional practices (HTPs) remains a concern. This study aimed at exploring and identifying harmful traditional cord care practices among mothers in a South Eastern Nigerian community. Method A cross-sectional study conducted among mothers who were conveniently enrolled; using a structured questionnaire. Data on sociodemographics, obstetric history, knowledge, and practices of cord care were collected and analyzed. Knowledge and practice scores were dichotomized into adequate/inadequate and good/poor. Descriptive statistics were presented as frequencies and percentages, categorical variables were compared using Chi square and analysis of the association between independent and dependent variables was explored using bivariate correlations. Result Of the 167 women that participated in this study 162 (97%) attended antenatal clinic (ANC) and 166 (99.4%) delivered in health facilities. Although 156 (93.4%) had been taught cord care, only 95 (56.9%)had adequate knowledge. However, 50 (29.9%) of the participants demonstrated poor cord care practices. Harmful substances applied to the cord included Vaseline 61 (19.9%), toothpaste 17 (5.6%), and, less commonly, breast milk, herbs and Mentholatum 2 (0.7%). Younger maternal age (&lt; 34 years) was significantly associated with poor practice (OR: 2.8, 95% CI: 1.22–6.60, p = 0.013). No sociodemographic factors were significantly associated with knowledge. Conclusion Harmful cord care practices are still key obstacles to embracing recommended cord care practices, despite high health facility utilization and average theoretical knowledge. This knowledge-practice gap highlights the insufficiency of education alone. Interventions should involveadvocacy to religious leaders/institutions, training and mentorshipprograms for community health workers, and active promotion and integration of affordable chlorhexidine gel into routine cord care practice. However, these conclusions apply only to facility-based mothers.

Patterns of recurrent preterm birth: an individual patient data meta-analysis.

Awareness, attitude, and anticipated willingness to use labor analgesia: a single-center antenatal survey study from a tertiary referral center in Saudi Arabia (2024).

Factors associated with major stressful life events in a 3-year naturalistic longitudinal screening of perinatal depression.

Malignant ovarian germ cell tumors (MOGCTs) are aggressive cancers affecting mainly young women, in whom fertility preservation is important. Diagnosis is often delayed because early symptoms are non-specific, leading to advanced disease or emergency surgery that may limit optimal staging and fertility-sparing treatment. As no effective screening exists and early detection improves survival, increased symptom awareness is essential. This study describes the demographic and clinical characteristics of MOGCTs to support earlier diagnosis. The present study is a descriptive-analytical cohort study conducted at Vali-ASR Hospital in Tehran, Iran, from 2001 to 2018. Patients with malignant ovarian tumors were evaluated with respect to demographic characteristics, obstetric and medical history, pathological findings, and clinical signs and symptoms before and at the time of diagnosis. The duration of symptoms was also recorded. Data was analyzed using SPSS version 24, employing descriptive statistical methods. The mean age of MOGCT cases (128 ones) was 23.88 ± 7.85 years. We found abdominal distension (45%) followed by acute pain (40.95%), chronic pain (23.95%), menstrual irregularity (14.7%), sense of abdominal firmness and mass (7.72%), nausea (5.4%), fever (5.4%), lack of apatite (4.63%), virilization (3.1%), and depletion of weight (3.1%). Abdominal distension and pain, acute or chronic, and menstrual disorders were the most common symptoms in all patients, but their incidence declined along with aging. The percentage of abdominal distention, ascites, and menstrual disorders in parous women was less than that of nullipara. MOGCTs present a significant diagnostic challenge due to their nonspecific and often misinterpreted symptoms, which vary notably by histologic subtype. Our findings emphasize that a high index of suspicion, coupled with an understanding of this symptom variability, is crucial for the timely diagnosis and improved management of these aggressive tumors, particularly in young women.

Obstetric anal sphincter injuries are associated with significant morbidity and increased recurrence risk in subsequent deliveries. In subsequent pregnancies, it is important to provide appropriate counseling and mode of delivery planning. The primary objective of this study was to determine the rate of obstetric anal sphincter injury counseling that patients with prior injury receive in their subsequent pregnancy. Secondary objectives include assessing the counseling quality, effect of counseling on delivery decisions, and counseling rates by patient risk factors. This was a descriptive cohort study through electronic medical record review at 2 academic institutions. Participants were identified using International Classification of Diseases, Ninth Revision and Tenth Revision codes and delivery summary documentation. A total of 218 patients met eligibility criteria, and of these, 39% received counseling on obstetric anal sphincter injury history in their first subsequent pregnancy. Patients with fourth-degree lacerations or at least 1 sequela, notably anal incontinence or psychological trauma, were the most likely to receive counseling. The cesarean delivery rate was significantly higher in the counseled group (25% vs 5%), and 62% of cesarean deliveries in the counseled group were performed for obstetric anal sphincter injury history. There was a low rate of obstetric anal sphincter injury counseling performed in the subsequent pregnancy. Further research is needed to understand the reason for low counseling rates and the role counseling plays in shaping delivery planning decisions.

Effective communication plays a crucial role in gestational diabetes mellitus (GDM) management, yet little research has examined whether healthcare professionals (HCPs) use motivational statements that align with patient preferences. This study investigates the alignment between the motivational statements used by HCPs and those preferred by women with GDM, applying self-determination theory (SDT) as a framework and using qualitative as well as quantitative techniques for analysing results. One hundred twenty-six pregnant women with GDM and 21 HCPs rated 27 motivational statements categorized into autonomy, competence, and relatedness components of SDT. Differences in statement ratings between groups were analysed using Mann-Whitney U tests with Bonferroni correction. A chi-square test was used to assess discrepancies between statements used by HCPs and statements written by patients. Spearman's correlations, Kruskal-Wallis tests, and Mann-Whitney U tests were used for associations between statement ratings and demographic characteristics (BMI, age, education level, history of GDM, obstetric history). The chi-square test revealed a significant misalignment. Women with GDM preferred competence-focused statements, whereas HCPs emphasized autonomy (χ2(2) = 6.228, p = 0.044). No significant associations were found between statement ratings and demographic variables. The study highlights the need for better alignment between HCPs' communication and patients' needs to enhance their sense of competence, which could improve adherence to treatment recommendations.

Recurrent abortion, also referred to as recurrent pregnancy loss, is a multifactorial reproductive disorder affecting 1–3% of women of reproductive age and remains a significant clinical and public health concern. This study aimed to determine the frequency of different causes of recurrent abortion and to describe the sociodemographic, clinical, and obstetric characteristics of affected women in Al-Muthana, Iraq. A cross-sectional study was conducted among 100 women diagnosed with recurrent abortion attending the obstetrics and gynaecology outpatient clinics at Samawah hospital between January and December 2025. Data were collected using structured questionnaires and medical record reviews, including demographic characteristics, obstetric history, medical conditions, and identified etiological factors. The mean age of participants was 30.8 ± 7.2 years, with the majority residing in urban areas (62.0%) and being housewives (78.0%). A high prevalence of overweight and obesity was observed (63.0% combined). Nearly half of the women were nulliparous (42.0%), and the mean number of abortions was 3.1 ± 1.2, with most losses occurring in the first trimester (mean gestational age 9.8 ± 3.5 weeks). Thyroid disorders (19.0%), diabetes mellitus (14.0%), and hypertension (11.0%) were the most common medical conditions. Endocrine disorders were the leading identified cause (22.0%), followed by anatomical abnormalities (18.0%), infections (12.0%), and antiphospholipid syndrome (10.0%). Multiple causes were identified in 15.0% of cases, while 23.0% remained unexplained. In conclusion, recurrent abortion in this population is associated with a high burden of modifiable risk factors, particularly metabolic and endocrine disorders. The persistence of unexplained cases highlights the need for advanced diagnostic approaches and comprehensive evaluation strategies to improve patient outcomes.

Premorbid hypercoagulability causes obstetric complications; therefore, anticoagulation from the preconception period and throughout pregnancy may be beneficial in cases of bad obstetric history (BOH). The aim of the study is to test this hypothesis; 115 patients with BOH and 38 healthy women without prior obstetric complications were examined. Patients with antiphospholipid syndrome were excluded, and the groups were matched based on the frequency of congenital thrombophilia. Hemostasis was assessed before and during pregnancy using the thrombodynamics assay and routine coagulation tests. Platelet function was characterized using a blood clot contraction assay and flow cytometry. All patients with BOH received enoxaparin (low molecular weight heparin (LMWH)) starting from the preconception period and aspirin after the tenth week of pregnancy. Doses were adjusted based on dynamic laboratory monitoring. In women with BOH, premorbid hypercoagulability was associated with platelet dysfunction due to chronic activation and exhaustion. With enoxaparin and aspirin treatment before and during pregnancy, hemostasis and platelet function improved progressively. By the second trimester, these parameters were comparable to normal levels. In patients with BOH receiving enoxaparin and aspirin, pregnancy outcomes were significantly more favorable compared with previous pregnancies. No hemorrhagic complications were observed. For women with BOH, the early and controlled use of LMWH starting from the preconception period, along with aspirin from the 10th through the 34th week of pregnancy, improves hemostasis, prevents obstetric complications, and significantly increases the likelihood of a favorable pregnancy outcome. These results were achieved through dynamic laboratory monitoring using novel hemostatic assays and platelet contractility as biomarkers.

Objective: Influenza and pertussis vaccines are recommended during pregnancy; however, uptake remains insufficient in many European countries, increasing the risk of preventable infections. Recent recommendations for maternal respiratory syncytial virus vaccination have been endorsed by scientific societies. This study evaluated maternal vaccination coverage, knowledge, attitudes, and factors influencing vaccine uptake among Lithuanian women. Methods: A retrospective cross-sectional online survey was conducted between 4 and 14 November 2025 in Lithuania among women aged 18-55 years with at least one previous pregnancy. The questionnaire contained 29 questions on sociodemographic characteristics, obstetric history, vaccination history, attitudes, and informational sources influencing decisions. Internal reliability was confirmed (Cronbach's α = 0.83). Descriptive statistics were used to summarize the data. Associations between categorical variables were assessed using the Chi-square test or exact tests (Fisher's exact or Fisher-Freeman-Halton). Binary and multivariable logistic regression analyses were performed to evaluate factors associated with self-reported vaccination uptake and the relationship between influenza and pertussis vaccination. Odds ratios with 95% confidence intervals were calculated. Statistical significance was set at p < 0.05. Results: A total of 241 women participated. Self-reported vaccination coverage during pregnancy was 28.7% for influenza, 43.8% for tetanus-diphtheria-pertussis, and 4.2% for respiratory syncytial virus. Physician's recommendation was the strongest predictor: women advised to vaccinate were 17.0 times more likely to receive influenza, 16.5 times more likely to receive pertussis, while RSV vaccination occurred almost exclusively among women who reported receiving a physician's recommendation. Higher uptake was associated with younger maternal age and university education. Reasons for declining vaccination were avoidance of medical interventions and concerns about safety or side effects. Conclusions: Maternal vaccination coverage in Lithuania remains low despite public funding and national recommendations. Strengthening provider communication, improving information strategies, and integrating vaccination counseling into routine antenatal care may increase uptake and enhance maternal and neonatal protection.

Background: Amniotic fluid volume abnormalities are common in high-risk pregnancies and reflect underlying maternal and fetal conditions, yet the distribution of specific maternal risk factors across different amniotic fluid categories remains insufficiently characterized. Objective: To evaluate the frequency and distribution of maternal high-risk factors across normal amniotic fluid volume, oligohydramnios, and polyhydramnios in high-risk pregnancies. Methods: This cross-sectional observational study included 81 high-risk pregnant women at ≥28 weeks gestation. Amniotic fluid volume was assessed using the amniotic fluid index and categorized as normal (5–25 cm), oligohydramnios (&lt;5 cm), or polyhydramnios (&gt;25 cm). Maternal risk factors, including hypertension, diabetes mellitus, preeclampsia, obstetric history, intrauterine growth restriction, and congenital anomalies, were recorded. Associations were analyzed using chi-square tests and odds ratios with 95% confidence intervals. Results: Normal amniotic fluid volume was observed in 60.5% of cases, oligohydramnios in 19.8%, and polyhydramnios in 19.8%. Intrauterine growth restriction was significantly associated with oligohydramnios (31.2% vs 8.2%; OR 5.13, p=0.02), while diabetes mellitus was strongly associated with polyhydramnios (37.5% vs 10.2%; OR 5.28, p=0.02). Hypertension and preeclampsia showed higher prevalence in oligohydramnios but were not statistically significant. The presence of ≥2 risk factors was associated with a threefold increase in abnormal amniotic fluid volume (OR 3.24, p=0.03). Conclusion: Maternal high-risk factors exhibit distinct distribution patterns across amniotic fluid categories, with oligohydramnios linked to placental insufficiency-related conditions and polyhydramnios associated with metabolic and structural factors. These patterns support targeted clinical evaluation and improved risk stratification.

Introduction: Preterm birth (PTB), defined as delivery before 37 completed weeks of gestation, remains a leading cause of neonatal morbidity and mortality worldwide. In India, PTB contributes significantly to neonatal complications and under-five mortality. Identifying determinants in highburden settings such as tertiary hospitals is essential for guiding preventive strategies. Methodology: A retrospective observational study was conducted over six months in the Department of Obstetrics and Gynaecology at a tertiary care hospital in South India. A total of 200 women who delivered during the study period were included based on eligibility criteria. Data were extracted from hospital records regarding maternal demographics, obstetric history, medical comorbidities, delivery characteristics, and neonatal outcomes. Descriptive statistics were applied, and associations were analysed using chi-square and logistic regression, with p &lt;0.05 considered significant. Results: The prevalence of PTB was 29%. Key determinants significantly associated with PTB included previous preterm birth (20.7% vs. 5.6%, p=0.002), multiple pregnancy (17.2% vs. 4.2%, p=0.004), hypertensive disorders (24.1% vs. 8.5%, p=0.003), antepartum haemorrhage (10.3% vs. 2.8%, p=0.045), and maternal anaemia (34.5% vs. 21.1%, p=0.048). Preterm neonates had higher rates of low birth weight (35%), NICU admission (27%), and complications such as respiratory distress (9%), jaundice (11%), and sepsis (7%) compared with term neonates. Conclusion: This study highlights a high burden of PTB in a tertiary hospital, with maternal and obstetric complications as key determinants. Strengthened antenatal surveillance, timely management of high-risk pregnancies, and larger multicentric studies are warranted to reduce PTB and improve neonatal outcomes.