Fetal Parameters Research Articles

Determination of the Normative Value of Fetal Left Brachiocephalic Vein Diameter Using Ultrasound in a Tertiary Care Hospital in Eastern India.

Fetal ultrasound plays a vital role in prenatal care by offering key insights into fetal growth and facilitating the early identification of congenital abnormalities. Among various anatomical structures, the fetal left brachiocephalic vein (FLBCV) plays a significant role in fetal circulation, yet normative data for FLBCV dimensions are limited, particularly in diverse populations. This study aims to establish normative values for FLBCV diameter in fetuses between 18 and 23 weeks of gestation in a tertiary care hospital in Eastern India. Such data are essential for accurate clinical assessment and early diagnosis of potential congenital anomalies. This descriptive study was conducted at the College of Medicine and Sagore Dutta Hospital, Kolkata, India, from January to December 2022. The study included 287 singleton pregnancies between 18 and 23 weeks of gestation, excluding cases with maternal or fetal conditions that could affect the measurements. LBCV diameter was measured using transabdominal ultrasound, and the normative values were established using percentile charts. Correlation analyses were performed to assess the relationship between FLBCV diameter and various fetal and maternal parameters. Linear regression analysis was done to identify significant predictors of FLBCV diameter. FLBCV diameter showed a consistent increase with gestational age, ranging from a median of 1.87 mm at 18 completed weeks to 2.27 mm at 22 completed weeks. The 95th percentile values exhibited more pronounced growth, particularly between 18 and 20 weeks. Significant positive correlations were observed between FLBCV diameter and fetal biometric parameters such as biparietal diameter, head circumference, abdominal circumference, and femur length. Head circumference emerged as the most significant predictor (p=0.007) of FLBCV diameter in the linear regression model. This study provides essential normative data on FLBCV diameter for the Indian population, offering a valuable reference for clinicians in prenatal diagnostics. The incorporation of FLBCV measurement in basic fetal echocardiography, which is a part of the second-trimester fetal anomaly scan, could enhance the detection of congenital anomalies, contributing to improved prenatal care.

A Comprehensive and Longitudinal View of Pregnancy from the Perspective of the Couple, Maternal Mental Health and Fetal Growth.

This study investigates the impact of both maternal psychopathological factors and adaptive psychological changes within the couple on fetal growth, emphasizing the importance of evaluating pregnancy from the perspectives of the couple, the mother, and the fetus collectively. A "couple" in this context refers to heterosexual partners engaged in the pregnancy process together, whether married or in a stable relationship. We included 189 pregnant women in their first trimester, tracking maternal depression, anxiety, body appreciation, prenatal attachment, and the couple's adjustment level across each trimester. Fetal growth parameters measured include biparietal diameter, femur length, humerus length, abdomen circumference, head circumference, β-HCG, and amniotic fluid levels, with relationships between these variables being modeled accordingly. Our findings indicate stable levels of maternal depression, anxiety, body appreciation, and couple's adjustment throughout the pregnancy, with a significant increase in prenatal attachment levels in each subsequent trimester. Prenatal attachment in the first trimester and maternal depression levels in the second and third trimesters were found to directly influence fetal growth, while other variables exhibited indirect effects. Fetal growth is influenced by a myriad of biopsychosocial factors. Ensuring healthy pregnancy and fetal development necessitates close monitoring and support of the mother's adaptive psychological changes, early identification and treatment of potential psychopathologies, and maintenance of the psychosocial health of the couple.

Correlation between morphometry of fetal foot and gestational age: a cadaver study

Objectives: This study was conducted on a collection of fetal cadavers to describe the relationship between gestational age and foot parameters specifically in the Turkish population. Methods: The study involved 83 fetal cadavers (45 males, 38 females) ranging from 13 to 40 weeks of gestation, without external anomalies or pathologies. Various foot parameters were measured, including foot width (FW), heel width (HW), foot length (FL), heel-metatarsophalangeal fold (HMF), bimalleolar width (BW), foot dorsum length (FDL), ankle-metatarsophalangeal fold (AMF), malleolus medialis height (MMH), malleolus lateralis height (MLH), and finger length (FiL). These parameters were measured using a digital caliper with a precision of 0.01 mm. The fetuses were grouped by gestational month, and morphometric measurements were taken. Results: A strong and positive correlation was found between all foot parameters and gestational age (months). All parameters increased consistently throughout the fetal period. No significant differences were observed based on gender or side comparisons for any of the parameters. Linear regression equations were developed to estimate gestational age using fetal foot parameters. These parameters explained 72% to 90% of the variation in gestational age. Conclusion: Fetal foot length and related foot parameters can reliably be used to estimate gestational age. Due to the simplicity of these measurements, fetal foot parameters can be utilized to estimate age for babies born outside a hospital setting without the need for specialist equipment. Additionally, for premature babies receiving treatment in neonatal units, foot measurements offer a practical and easily accessible method for age estimation.

Comprehensive evaluation of fetal renal ultrasound parameters for fetal growth restriction

ObjectiveThis study aims to investigate variances in renal ultrasound parameters between fetuses experiencing fetal growth restriction (FGR) and those with normal intrauterine development, with the intent to offer actionable insights for clinical management. MethodForty-five pregnant women diagnosed with FGR between 28 and 36 weeks of gestation, who underwent examination at Wenzhou People's Hospital from September 2021 to June 2023, constituted the FGR group. Concurrently, 65 pregnant women with normal intrauterine development at matching gestational weeks formed the control group. Renal ultrasound parameters, encompassing renal artery peak systolic velocity (PSV), end diastolic velocity (EDV), time averaged maximum velocity (TAMX), resistive indices (S/D, PI, RI), ratios of renal volume to gestational age (RV/WEEK) and estimated fetal weight (RV/EFW), vascular indices (VI, FI, VFI), were compared between the two groups. All parameters represented the mean values of bilateral kidneys. ResultIn the FGR group, fetal renal artery PSV (37.71 ± 9.93 cm/s), EDV (6.19 ± 1.50 cm/s), TAMX (15.10 ± 3.83 cm/s), RV/WEEK (0.45 ± 0.12), RV/EFW (7.53 ± 3.24), VI (22.19 ± 15.00), and VFI (5.53 ± 3.63) were significantly lower compared to the control group (PSV: 47.11 ± 11.24 cm/s, EDV: 7.13 ± 2.00 cm/s, TAMX: 17.85 ± 3.85 cm/s, RV/WEEK: 0.66 ± 0.19, RV/EFW:9.20 ± 3.17, VI: 28.67 ± 14.72, VFI: 7.40 ± 3.68). Conversely, fetal renal artery resistive indices (S/D: 9.09 ± 2.58, PI: 2.71 ± 0.56, RI: 0.92 ± 0.04) in the FGR group were notably higher than those in the control group (S/D: 6.22 ± 1.93, PI: 2.20 ± 0.73, RI: 0.87 ± 0.04), with statistical significance (P < 0.05). No significant difference was found in renal FI between the FGR group (26.78 ± 6.59) and the control group (26.89 ± 5.82) (P > 0.05). Receiver operating characteristic (ROC) curve analysis revealed higher diagnostic efficacy for RV/WEEK and RI among individual indicators, while combined parameter application yielded the highest diagnostic efficiency. ConclusionUtilizing a comprehensive evaluation of fetal kidney ultrasound parameters with multiple indices facilitates early screening and diagnosis of FGR fetuses, thereby aiding clinical decision-making and enhancing newborn birth outcomes.

Artificial Intelligence-Based Estimation of Fetal Head Circumference With Biparietal and Occipitofrontal Diameters Using Two-Dimensional Ultrasound Images

Abstract One of the most essential biometrics for measuring fetal growth during prenatal ultrasound exams is the head circumference (HC). However, manual measurement of this biometric by doctors often needs substantial experience. Manual measurement of fetal head circumference during prenatal ultrasound exams requires significant expertise, posing limitations in accuracy and consistency, which can impact clinical decision-making and fetal health assessments. We developed a state-of-the-art image processing algorithm that utilizes biometry and segmented images and employed a fast ellipse fitting method to measure the HC, head orientation (angle) along with biparietal (BPD), and occipitofrontal (OFD) diameter automatically. Our approach offers automation and precision in measuring fetal biometrics, surpassing the limitations of manual measurement by ensuring consistent and accurate assessments, thus enhancing clinical efficiency and facilitating timely interventions for optimal fetal health management. Additionally, to the best of our knowledge, this is the first work that adopts a segmented image from any model or technique and provides significant fetal parameters during ultrasonography in a single shot. The suggested technique is lightweight, real-time, and easily integrate with any segmentation model or technique. We have used three well-known segmentation models for demonstration and compared their performance using dice scores as an evaluation parameter. Among the three, HRNet shows the best results with an average dice score of 0.96; due to the high dice score, we have chosen HRNet over the other two models and proceeded further and implemented our novel algorithm on that to predict the required fetal key measurements. The findings of this study benefit prenatal care by enhancing the accuracy and efficiency of fetal biometric measurements, thereby facilitating improved clinical decision-making and optimizing fetal health assessments.

Association between gestational arsenic exposure and infant physical development: a prospective cohort study

BackgroundArsenic pollution is widespread worldwide. The association between gestational arsenic exposure and adverse birth outcomes has been demonstrated in previous studies; however, few investigations have examined whether gestational arsenic exposure has adverse effects on infant growth and development after birth.ObjectiveOur study was designed to evaluate particular associations between gestational arsenic exposure during pregnancy and newborn birth size and to investigate whether these associations continue to affect infants after birth.MethodsAn ongoing prospective cohort study of 1100 pregnant women was conducted at the Wuxi Maternity and Child Health Care Hospital. The total urinary arsenic concentrations in the 2nd and 3rd trimester were determined using atomic fluorescence spectrometry. The relationships between urinary arsenic concentration and foetal growth parameters (birth weight, head circumference, length, and ponderal index), SGA (Small for gestational age), and physical growth of infants within one year after birth were analysed.ResultsUrinary arsenic concentration in the 3rd trimester was associated with an increased incidence of SGA [adjusted model: OR = 2.860 (95% CI: 1.168, 7.020), P = 0.021)]. Arsenic exposure in late pregnancy had an adverse effect on the physical development of infants before the age of 1 year, and there was an interaction effect with the sex of infants. The weight and length of boys at 6 and 12 months negatively correlated with maternal urinary arsenic levels during late pregnancy.ConclusionsIn addition to affecting foetal growth, exposure to arsenic in the 3rd trimester also negatively affected the growth of offspring within the first year of life.

Assessment of Fetal Ventricular Size and Shape in Women With Intrahepatic Cholestasis of Pregnancy Using Speckle Tracking.

To examine the effect of intrahepatic cholestasis of pregnancy (ICP) on fetal heart morphology. This case-control study was conducted with 40 women with ICP and 54 pregnant controls. Fetal heart quantification based on speckle tracking technology was used to assess the morphology of the fetal right and left ventricles. Routine ventricular size parameters, global and 24-segment spherical indices (SIs) were measured and compared between groups. The routine fetal cardiac parameters, global and right-ventricular SIs did not differ between the ICP and control groups. The left-ventricular apical (segments 16-24) SIs were lower in the ICP group than in the control group (P < .05), with no significant difference in the other left-ventricular segments. Subclinical morphological changes were observed in the left ventricular apical segments of the fetal hearts in women with ICP, which indicates an intrauterine environment with high bile acid concentrations. Twenty-four-segment SIs can be used to effectively evaluate these changes.

Assessment of fetal development during mid and late term pregnancies by standard B-Mode ultrasonography in Shetland ponies

Transrectal and transabdominal ultrasonography is an established method to monitor pregnancy, fetal growth and wellbeing in different species. Growth charts with multiple bio-morphometric parameters to estimate days of gestation and days before parturition exist in small companion animals, sheep and goats, riding type horses and large ponies but not in small horse breeds like Shetland ponies. The aim of this study was to apply fetal biometric assessment and detailed description of physiologic fetal development to mid and late term pregnancies in Shetland mares and to generate reference data for clinical practice and for future research. Fetal parameters were collected starting on day 101 of pregnancy in five Shetland mares. The fetal biometric parameters determined consisted of aortic diameter, eye diameter, combined rib and intercostal distance (CRID), stomach length and width and different heart morphology parameters in sagittal and frontal plane. Additionally, fetal activity and organ development in terms of differentiation and changes in echogenicity were recorded. Considering reliably assessable parameters, fetal CRID was the best predictor for gestational age with ± 13.6 days and fetal aortic diameter the most accurate for prediction of days until parturition with ± 16.2 days.

Segmentation and Estimation of Fetal Biometric Parameters using an Attention Gate Double U-Net with Guided Decoder Architecture

The fetus's health is evaluated with the biometric parameters obtained from the low-resolution ultrasound images. The accuracy of biometric parameters in existing protocols typically depends on conventional image processing approaches and hence, is prone to error. This study introduces the Attention Gate Double U-Net with Guided Decoder (ADU-GD) model specifically crafted for fetal biometric parameter prediction. The attention network and guided decoder are specifically designed to dynamically merge local features with their global dependencies, enhancing the precision of parameter estimation. The ADU-GD displays superior performance with Mean Absolute Error of 0.99 mm and segmentation accuracy of 99.1 % when benchmarked against the well-established models. The proposed model consistently achieved a high Dice index score of about 99.1 ± 0.8, with a minimal Hausdorff distance of about 1.01 ± 1.07 and a low Average Symmetric Surface Distance of about 0.25 ± 0.21, demonstrating the model's excellence. In a comprehensive evaluation, ADU-GD emerged as a frontrunner, outperforming existing deep-learning models such as Double U-Net, DeepLabv3, FCN-32s, PSPNet, SegNet, Trans U-Net, Swin U-Net, Mask-R2CNN, and RDHCformer models in terms of Mean Absolute Error for crucial fetal dimensions, including Head Circumference, Abdomen Circumference, Femur Length, and BiParietal Diameter. It achieved superior accuracy with MAE values of 2.2 mm, 2.6 mm, 0.6 mm, and 1.2 mm, respectively.

External validation of models to estimate gestational age in the second and third trimester using ultrasound: A prospective multicentre observational study.

Accurate assessment of gestational age (GA) is important at both individual and population levels. The most accurate way to estimate GA in women who book late in pregnancy is unknown. The aim of this study was to externally validate the accuracy of equations for GA estimation in late pregnancy and to identify the best equation for estimating GA in women who do not receive an ultrasound scan until the second or third trimester. This was a prospective, observational cross-sectional study. 57 prenatal care centres, France. Women with a singleton pregnancy and a previous 11-14-week dating scan that gave the observed GA were recruited over an 8-week period. They underwent a standardised ultrasound examination at one time point during the pregnancy (15-43 weeks), measuring 12 foetal biometric parameters that have previously been identified as useful for GA estimation. A total of 189 equations that estimate GA based on foetal biometry were examined and compared with GA estimation based on foetal CRL. Comparisons between the observed GA and the estimated GA were made using R2, calibration slope and intercept. RMSE, mean difference and 95% range of error were also calculated. A total of 2741 pregnant women were examined. After exclusions, 2339 participants were included. In the 20 best performing equations, the intercept ranged from -0.22 to 0.30, the calibration slope from 0.96 to 1.03 and the RSME from 0.67 to 0.87. Overall, multiparameter models outperformed single-parameter models. Both the 95% range of error and mean difference increased with gestation. Commonly used models based on measurement of the head circumference alone were not amongst the best performing models and were associated with higher 95% error and mean difference. We provide strong evidence that GA-specific equations based on multiparameter models should be used to estimate GA in late pregnancy. However, as all methods of GA assessment in late pregnancy are associated with large prediction intervals, efforts to improve access to early antenatal ultrasound must remain a priority. The proposal for this study and the corresponding methodological review was registered on PROSPERO international register of systematic reviews (registration number: CRD4201913776).

Effects of 'dedo de moça' pepper extract administration on wistar rat pregnancy and fetal development

Introduction: The dedo de moça pepper is spicy due to capsaicin, which activates receptors in sensory neurons, generating a burning sensation. Studies suggest that capsaicin-sensitive neurons, by releasing neuropeptides, may affect uterine contraction. Objective: To evaluate the effect of chronic administration of capsaicin extract (Cps) during pregnancy in Wistar rats and their fetuses. Methodology: Pregnant female Wistar rats were divided into 4 groups (n = 5/group): Group I – Negative Control; Group II – Positive Control; Group III – Cps 1 – 0.25 mL; Group IV – Cps 2 – 0.5 mL. Exposure was initiated after embryo implantation (3rd day of pregnancy) until full term (20th day of pregnancy), with gavage performed three times per week. Results: On the 20th day, pregnant rats were euthanized, and outcomes evaluated included weight gain, placental morphology, reproductive capacity, and embryonic/fetal development. Ingestion of capsaicin extract resulted in negative impacts on fetal intrauterine growth parameters and placental alterations, with deposition of atypical hyaline material for gestational age and changes in vascular structures. Conclusion: The results indicate that capsaicin extract interfered with placental exchange, leading to intrauterine growth restriction of the fetuses.

Hematological and Coagulation Factors in Term and Preterm Newborns of Mothers with Pre-eclampsia

Objective: Pre-eclampsia (preE) is pregnancy-induced hypertension affecting a significant proportion of pregnant women worldwide and can cause detrimental effects on the mother and newborn. Recognition of contributing factors of health in neonates with pre-eclamptic mothers is important to reduce the burden of the problem. The aim of the study was to determine the hematologic and coagulation factors in term and preterm neonates born to mothers with pre-eclampsia. Method and Materials: In this observational cross-sectional comparative study, 104 neonates born to mothers with pre-eclampsia in Imam-Hossein Hospital from 2018 to 2021 were enrolled. The neonates were divided into term and preterm groups according to the gestational age of the mothers. Maternal and fetal parameters of neonates were collected. The hematologic and coagulation factors were recorded and compared. Results: The finding of the study demonstrated that the mean leukocyte (P=0.030), hemoglobin (P=0.0001), and platelet (P=0.0001) were significantly higher in term neonates. The mean PT (P=0.003), PPT (P=0.001), and INR (P=0.003) were significantly higher in preterm cases. Conclusion: Totally, according to the obtained results it may be concluded that CBC indexes and coagulopathy in term and preterm neonates born to mothers with pre-eclampsia are significantly different.

Assessing Severity and Need for Delivery in Early Onset Preeclampsia Before 32 Weeks of Gestation: a Delphi Consensus Procedure.

Preeclampsia is a potentially life-threatening hypertensive pregnancy disorder that carries an acute risk of an unfavorable outcome of the pregnancy but also has consequences for the long-term health of the mother. Women who develop the early form of pre-eclampsia before the 32nd week of pregnancy have the highest risk and are also the most difficult to treat. The severity of pre-eclampsia is not characterized uniformly in Germany, so that the indication for delivery is rather individualized. The aim of this study was to reach a consensus on parameters that could serve as criteria for describing the severity of pre-eclampsia based on the urgency of delivery. To this end, a Delphi procedure was used to present a scenario in which a woman was admitted for preeclampsia before 32 gestational weeks and after completion of antenatal steroid therapy. Clinicians specialized in maternal-fetal medicine from German-speaking countries completed five rounds of a modified Delphi questionnaire. Presented parameters were selected by the section "Hypertensive Pregnancy Diseases and Fetal Growth Restriction" of the German Society of Gynecology and Obstetrics after reviewing the literature. These included objectifiable laboratory or clinical parameters as well as subjective symptoms of the patient. In addition, nine fetal parameters were taken into account. The clinicians were asked to rate presented parameters as an indication for delivery on a Likert scale from 0 to 4 (no indication to absolute indication without delay). For each item, the predefined cut-off for group consensus was ≥70% agreement. A total of 126 experts were approached. Sixty-nine experts (54.8%) took part in the first round; of those 50 completed the entire Delphi procedure. A consensus was reached on 14 parameters to be considered rapid preparation for delivery without delay (4 points on the Likert scale). These were among others hepatic hematoma or liver capsule rupture, acute liver failure with fulminant coagulation disorder or disseminated intravascular coagulation, eclampsia, pathologic findings in imaging (e.g. cMRI) or electrocardiogram arranged for new onset of headache or retrosternal pain, respectively. Twenty-six parameters were rated as factors that should be considered in the decision without being absolute (1 to 3 points), and 13 parameters should have no influence on the decision to deliver (0 points). No consensus on severe hypertension as an indication for delivery could be reached for blood pressure values below 220/140mmHg. A consensus was reached on whether to deliver in preeclampsia typic clinical findings and symptoms. The results can serve as guidance for current clinical practice and for the definition of clinical endpoints in intervention studies. Nevertheless, the isolated criteria are a theoretical construction since the combined deterioration or summation of several factors rather than a single factor most likely influences the decision to deliver and reflect the severity of preeclampsia. Moreover, the degree of hypertension as an indication for delivery remains controversial, unless the patient suffers additionally from complaints. Future research should be enforced to incorporate long-term risks for the mother into a decision aid.

Evaluating fetal lung development at various gestational weeks using two-dimensional shear wave elastography.

Noninvasive evaluation of fetal lung development is a critical area of study. Two-dimensional shear-wave elastography (2D-SWE) provides valuable insights into tissue stiffness, potentially correlating with different stages of lung development. This study aims to explore the potential of the 2D-SWE technique for assessing the maturity of fetal lung development. This prospective cohort study included pregnant women undergoing routine antenatal ultrasound examinations at the Second Affiliated Hospital of Fujian Medical University and Quanzhou Women's and Children's Hospital from September 2022 to September 2023. The study consecutively recruited 300 pregnant women with normal pregnancies and 15 who opted for induced labor. Among those with normal pregnancies, the study assessed the differences in fetal pulmonary and hepatic elasticity measurements across different gestational weeks (GW) using one-way analysis of variance (ANOVA). Furthermore, regression analyses using linear, quadratic, and cubic equations were conducted to investigate the relationship between fetal parameters and GW. For those who opted for induced labor, elasticity measurements were taken before induction, and fetal lung tissue specimens were collected for post-induction observation. Fetal lung and liver elasticity values, along with the lung-to-liver elasticity ratio (LLE ratio), showed significant variations across different GW (P<0.05). Specifically, fetal lung elasticity values initially increased and then decreased as GW advanced (R2=0.41). Liver elasticity values continuously increased throughout GW, though the rate of increase diminished during the prenatal period (R2=0.37). The LLE ratio values increased and then decreased over GW, fluctuating overall between 0.8 and 0.9 (R2=0.14). A 71.4% concordance was observed between the predicted stage of lung development, based on lung elasticity values, and the histological stage of lung development in the induced fetuses. 2D-SWE can depict the maturation of fetal lung development at various stages.

Ultrasound parameters of arteries and heart in normal fetuses

BackgroundCurrently, no normal ultrasound data of the fetuses during the 20–40 gestation have been obtained for references of fetal growth and development. If such ultrasound data existed for prenatal diagnosis of possible diseases and abnormalities, neonates would be able to get timely treatment immediately after birth. This study was thus performed to obtain ultrasound parameters of normal fetuses during the 20–40 week gestation and the distribution of ultrasound parameters with the gestational age for references of detecting potential fetal diseases and abnormalities.MethodsNormal fetuses without any abnormalities were enrolled, and the ultrasound parameters of the general biology, arteries, and aorta were measured and analyzed.Results417 normal fetuses were enrolled. A significant (P < 0.05) negative correlation with the gestational age was detected in the peak systolic velocity/peak diastolic velocity (S/D), pulsatility index (PI) and resistance index (RI) of the umbilical artery (UA). A relatively stable relationship with the gestational age was detected in the fetal weight%, S/D, PI and RI of the middle cerebral artery (MCA), peak systolic velocity (PSV) and velocity time integral (VTI) of the intra-abdominal UA, fetal heart to chest ratio, mitral valve (MV)- and tricuspid valve (TV)-E/A peak flow velocity, aortic isthmic Z-score and displacement, distance between the brachiocephalic artery-left common carotid artery (BA-LCCA) and LCCA-left subclavian artery (LSA), Z-score of aorta, ascending aorta (AAO), pulmonary artery (PA), main pulmonary artery (MPA), and descending aorta (DAO). A significant (P < 0.05) positive correlation with the gestational age was detected in the fetal biological data, MCA PSV and VTI, free-UA PSV and VTI and cardio-thoracic ratio, cardiac parameters, ductus arteriosus (DA) and isthmus diameter, aortic parameters, PA and MPA diameter, MPA PSV and VTI, isthmus flow volume and velocity and PA flow volume, DA and BA parameters, and LCCA and LSA parameters (flow volume, PSV, and VTI).ConclusionA certain correlation and distribution trend is detected in the ultrasound parameters of normal fetuses, and the ratios among different parameters remain relative stable. These findings can be used for determination of abnormal growth of the fetuses in prenatal ultrasound scan.Graphic

Effects of thalassemia minor on umbilical artery blood flow and perinatal outcomes in pregnancy: A retrospective cohort study.

The aim of the present study was to compare the fetal umbilical artery blood flow parameters in the third trimester and perinatal outcomes between pregnant women with and without thalassemia minorin South China. This was a retrospective cohort study. Doppler ultrasound was used to detect fetal umbilical artery hemodynamics in pregnant women with or without thalassemia minor during the third trimester. The main parameters assessed were umbilical artery peak systolic flow velocity/end-diastolic flow velocity (S/D), resistance index (RI), pulsation index (PI), and relevant perinatal outcomes. This study included 540 pregnant women, 180 with thalassemia minor and 360 being healthy controls. In the third trimester, the thalassemia minor group had higher umbilical artery S/D (P = 0.002), RI (P = 0.002), and PI (P = 0.012) than healthy pregnant women, as well as lower levels of hemoglobin (Hb) (P < 0.001) and higher ferritin levels (P < 0.001). Compared to the non-thalassemia group, neonatal body weight in the thalassemia minor group was significantly lower (P = 0.001). Additionally, the incidence of maternal anemia (odds ratio [OR] 3.92; 95% confidence interval [CI]: 2.57-5.99, P < 0.001), low birth weight (OR 15.35; 95% CI: 1.71-137.93, P = 0.015), fetal distress (OR 2.18; 95% CI: 1.12-4.26, P = 0.023), neonatal asphyxia (OR 12.81; 95% CI: 1.40-117.33, P = 0.024), oligohydramnios (OR 18.25; 95% CI: 2.21-150.36, P = 0.007) and Apgar score <7 at 1 min after birth (OR 7.97; 95% CI: 1.53-41.54, P = 0.014) was significantly higher in the thalassemia minor group. Pregnant women with thalassemia minor have higher umbilical artery S/D, RI and PI during the third trimester and a higher risk of adverse perinatal outcomes.

Effect of maternal asthma on fetal pulmonary artery Doppler parameters: a case-control study.

To compare fetal pulmonary artery Doppler parameters between pregnant women with asthma and healthy pregnant women. This prospective, cross-sectional study was conducted on 50 pregnant women diagnosed with asthma and 61 healthy pregnant women. Fetal pulmonary artery Doppler parameters and the fetal main pulmonary artery acceleration time/ejection time (PATET) ratio were compared between the study and control groups. Thereafter, the study group was divided into two subgroups as non-severe and severe asthma. PATET ratio was compared between the subgroups. The fetal main pulmonary artery acceleration time was 25 ms in pregnant women with asthma and 33 ms in the healthy group, indicating a statistically significant difference (p=0.001). The acceleration time/ejection time ratio was statistically lower in the asthma group (0.185 vs. 0.240, p<0.001). The acceleration time/ejection time ratio was 0.172 in patients with severe asthma and 0.195 ms in the non-severe study group (p=0.156). In the maternal asthma group, the PATET ratio of those who went to the NICU due to respiratory distress was also 0.188, and the PATET ratio of those who went to the NICU for other reasons was 0.269 (p=0.053). Fetal pulmonary artery acceleration time and PATET decreased statistically in pregnant women with severe or non-severe asthma. Maternal asthma is associated with changes in pulmonary Doppler parameters in the fetus.

Decoding Fetal Growth: Exploring Proximal Tibial Epiphysis Ossification Center as an Additional Sonographic Fetal Biometry Parameter (34-40 Weeks Gestation)

Background: Many times, pregnant women don't know when they last had their period. Determining gestational age becomes extremely difficult when late booking for prenatal care is added. Study was conducted to ascertain the predictive values of proximal tibial epiphyseal ossification center measurements in estimating pregnancy in the third trimester.Objectives: To assess correlation between proximal tibial epiphysis ossification center diameter with respect to gestational age, from 34 weeks to 40 weeks of gestation. Materials and Methods: The study was carried out at Sughra Shafi medical complex, Narowal for a period of 9 months. Total 281 pregnant females were considered in this study which were within 34 weeks to 40 weeks of gestational age, with no-comorbidity and sure of their last menstrual period (LMP). An informed consent was taken. Measurement was repeated thrice, after confirming the proximal tibial epiphyseal ossification center and the largest diameter obtained in millimeters was recorded. Pearson correlation analysis was applied to see correlation between distal femoral epiphyseal ossification size and gestational age.Results: There is an increasing trend of the size of PTE ossification center (mm) as the gestational age proceeded from 34 weeks to 40 weeks. Pearson Correlation was applied. It was statistically significant indicating positive correlation indicated by coefficient of 1.Conclusion: In the third trimester, estimation of age of gestation by measuring the PTE is a reliable diagnostic tool in patients unsure of LMP as PTE appears in majority of patients by 34 weeks.Keywords: Gestational age, Last menstrual period, Ossification center, Proximal tibial epiphysis

Female Mice Exposed to Pyriproxyfen Since Prepuberty Showed Reproductive Impairment During Sexual Maturity and Increased Fetal Death in Their Offspring.

Pyriproxyfen (PPF) is an insecticide used in agriculture, which is approved for use in drinking water tanks for human consumption. However, some studies indicate that it may act as an endocrine disruptor and affect nontarget organisms. This study aimed to evaluate the effects of PPF on reproduction and general health status in female mice exposed from pre-puberty to adulthood. In the first experiment, females were treated by gavage from postnatal day (PND) 23 to (PND) 75 and were distributed into three experimental groups: control (vehicle), PPF 0.1 mg/kg, and PPF 1 mg/kg. Female mice were assessed for the age of puberty onset, body mass, water and food consumption, and the estrous cycle. On PDN 75, a subgroup was euthanized, when vital and reproductive organs were collected and weighed. The thyroid, ovary, and uterus were evaluated for histomorphometry. The other subgroup was assessed in relation to reproductive performance and fetal parameters. In a second experiment, the uterotrophic assay was performed with juvenile females (PND 18) using doses of 0.01, 0.1, or 1 mg/kg of PPF. PPF treatment reduced thyroid mass and increased liver mass. Furthermore, there was an increase in ovarian interstitial tissue and, in the uterus, a decrease in the thickness of the endometrial stroma with reduced content of collagen fibers. There was also a reduction of 30% in pregnancy rate in the treated groups and an increase in the frequency of fetal death. This study suggests that, based on this experimental model, the insecticide may pose a reproductive risk for females chronically exposed to the substance from the pre-pubertal period until adulthood. These results raise concerns about prolonged exposure of women to the same compound.

Deep Learning Techniques for a Comprehensive Analysis of Fetal Biometric Parameters Across Trimesters

The process of creating fetal images from the uterus using sound influence is known as fetal ultrasound imaging. During this scan, measurements such as the gestational sac, biparietal diameter, head circumference, abdominal circumference, and femur length can be taken from the mother, which are further analyzed by the radiologist or gynecologist. These factors allow us to quickly test for anomalies and monitor the fetal growth and development of a baby. This paper delves into the techniques utilized in previous studies for analyzing abnormalities from ultrasound images using machine learning and deep learning techniques. Specifically, we focus on two trimesters and three key fetal parameters: Head Circumference (HC), Abdominal Circumference (AC), and Femur Length (FL). Our proposed method, the Unet segmentation method, not only performs segmentation but also predicts the parameters. We employ various transfer learning techniques for classification. The experiment involves 1,313 medical fetal images, comprising 563 from the second trimester and 750 from the third trimester. In terms of segmentation accuracy, the results for the second trimester's biometric parameters are as follows: AC = 69.09%, FL = 92.02%, and HC = 69.43%. For the third trimester, the accuracy for FL is 90.04%, and for HC, it is 69.76%. Regarding classification methods, MobileNet and XceptionNet yield comparable results. For the second trimester, MobileNet achieves 99.28%, and XceptionNet achieves 99.82%. For the third trimester, both MobileNet and XceptionNet achieve 99.86%.