Gestation Period Research Articles

Determinants of Adverse Pregnancy Outcomes among Women Attending Antenatal Care-Clinic in Public Health Facilities in Nyando Sub-County, Kenya

Adverse pregnancy outcome (APO) refers to gestation results other than vaginal birth, which include premature birth, miscarriage and low birth weight which are main causes of maternal and neonatal illness and death. In Kenya, the maternal mortality ratio stands at 355 deaths per 100,000 live births. In Kisumu County maternal mortality rate stands at 495 per 100,000 live births per year and Nyando Sub-County has the second- worst record of adverse pregnancy outcomes. Therefore, the current the current study assessed the determinants of adverse pregnancy outcomes among women attending 4 selected public health facilities in Nyando Sub-County. In this multicenter hospital-based cross-sectional study, n=301 women who delivered at the 4 randomly selected hospitals Nyando Sub-County hospital and visited the ANC department at least twice were systematically randomly recruited from November 2022 to September 2023. Data was collected using pre-tested and structured questionnaire which consisted of sections of demographic and obstetric characteristics. Presence of at least one maternal complication was used to determine the presence of APO. SPSS version 27 was used for data analysis. Chi-square ( 2) was used to compare proportions based on pregnancy outcomes as normal and adverse. Association between socioeconomic status and APO, obstetric factors and APO as well as ANC visits and APO were determine using Binary logistic regression. Of the 301 participants, 96 (31.9%) had normal pregnancy outcome (NPO) while 205 (68.1%) had APO. Woman’s age, parity, marital status, family income and education were associated with APO p=0.001, p=0.001, p=0.001, p=0.001 and p=0.04 respectively. With regard to obstetric factors, women of between 16-35 years were less likely to develop APO [OR=0.410, 95% CI=0.260-0.670, p=0.001]. In terms of gestation period with 37 weeks as the reference group, women with 28-37 weeks of gestation are less likely to develop APO [OR=0.114, 95% CI=0.132- 0.497, p=0.001]. The study did not find any association with the number of ANC visits [OR=0.39 95% CI=0.36-1.26, p=0.314] however, women visiting ANC in the second trimester less likely to develop APO [OR=0.221, 95% CI=0.142-0.927, p=0.001]. Therefore, both sociodemographic and obstetric factor affect pregnancy outcome and early ANC visit is associated with better or normal pregnancy outcome.

Relationship Between Level of Maternal Knowledge about Nutrition of Pregnant Women with the Incidence of Stunting in Children Under Five

ABSTRACT Stunting can be caused by several factors, including poor nutritional intake during pregnancy in toddlers. Some of them are readiness to become mothers where this is motivated by a very high rate of early marriage. Unpreparedness in facing motherhood can affect perceptions in parenting. This study aims to determine the relationship between the level of maternal knowledge about nutrition of pregnant women with the incidence of stunting in children under five in Sisir Village, Batu City with a cross-sectional analytical descriptive design involving 56 respondents consisting of maternal respondents and toddlers aged 1-5 years with purposive sampling techniques. Data were collected with maternal knowledge level questionnaires during pregnancy and z score graphs. Results: Data analysis using Spearman Rank test with α = 0.05. The results showed that the significance value (sig) or p value was 0.009. Because the value of sig (0.009) > (0.05) with a correlation value of 0.347, the results of the data obtained from respondents mean h0 rejected h1 accepted. There is a relationship between the level of knowledge of parents and the incidence of stunting in toddlers. The results of the study concluded that there is a significant relationship between the level of knowledge of parents and the incidence of stunting in toddlers. Discussion: In Batu city comb sub-district. It is hoped that mothers can try to find knowledge and information related to nutrition and other factors that can cause stunting, and mothers can start paying attention to nutrition during pregnancy for preventive measures against the impact of stunting on the development of the next child at birth. Keywords: Maternal Knowledge, Gestation Period, Incidence Of Stunting

Ultrasonographic Assessment of the Thymus Among Neonates Admitted in a Special Newborn Care Unit of a Medical College Hospital in Eastern India.

The thymus is essential for the maturation of T-lymphocytes, crucial for adaptive immunity. In neonates, thymic development is influenced by factors such as gestational age, birth weight, birth length, etc. Ultrasonography offers a non-invasive method to assess thymic size and morphology. However, there is limited research on thymic ultrasonography among neonates in Eastern India. This study aimed to investigate the ultra-sonographic characteristics of the thymus in neonates admitted to a Special Neonatal Care Unit (SNCU) in Eastern India and its correlation with certain clinical and anthropometric variables. Conducted from May to July 2024, this cross-sectional observational study involved 80 neonates admitted to the SNCU at the College of Medicine & Sagore Dutta Hospital. Thymic ultrasonography, using an Esaote MylabX7 ultrasound machine with a 3-11 MHz linear probe (Esaote, Genoa, Italy), measured thymic length, width, anteroposterior (AP) dimension, sagittal area, and thymic index. Clinical data, including gestational age, birth weight, birth length, and antibiotics received, were collected from medical records. Pearson's correlation coefficient and linear regression analysis were used to examine correlations and predictors of thymic dimensions. The cohort consisted of 45 boys (56%) and 35 girls (44%). The average birth weight was 2,626 grams for boys and 2,639 grams for girls. The median gestation period was 38 weeksfor both groups. Thymic measurements did not significantly differ by gender. Correlation analysis revealed significant relationships between thymic dimensions and neonatal anthropometric measurements. Birth weight showed a strong positive correlation with thymic length (r = 0.486) and width (r = 0.233). Linear regression identified birth weight as a significant predictor of the thymic index (p < 0.001), explaining 21.2% of the variance. This study provides insights into the factors associated with thymic size in neonates, highlighting the critical role of birth weight in thymic development. Future research should explore additional variables influencing thymic size and consider larger sample sizes to enhance model explanatory power and its potential role in immunity.

Cucumeropsis mannii seed oil mitigates bisphenol-A-induced sperm and hormonal damages in F1-generation of F0-exposed male rats: An in-vivo and in-silico analysis

Exposure to endocrine-disrupting chemicals such as bisphenol A (BPA) has been linked to the sharp drop in male fertility observed worldwide. This study evaluates the protective benefits of Cucumeropsis mannii seed oil (CMSO) against BPA-induced transgenerational sperm indices and reproductive hormone disruptions in rats. Twenty-four F0-male rats (aged 4–5 weeks) were randomly assigned to six groups (n = 4 each) after CMSO characterization for flavonoids. Group A received 1 ml of olive oil. Group B received 100 mg/kg body weight (BW) of BPA whereas Group C had a BW of 7.5 ml/kg CMSO. Groups D, E, and F were administered 100 mg/kg_BW of BPA in addition to 7.5, 5.0, and 2.5 ml/kg_BW of CMSO, respectively. After two weeks of treatment, four mature female rats were introduced to each group and allowed to stay together with male rats for seven days to confirm mating. Thereafter, the pregnant female rats were separated from the male according to their groups and allowed to give birth after 21 days of gestation period. At six weeks, the F1-male rats were isolated from each group and sacrificed for biochemical analysis. In-silico, CMSO flavonoids were assessed for drug-likeness and oral absorbability, followed by molecular docking to study their androgen receptor targeting mechanisms. Results showed that total flavonoids were 17.3652 ± 8.85 g/100 g. In-vivo, BPA significantly (p < 0.005) dysregulated sperm indices and male fertility hormones in F1 rats, but co-administration with CMSO restored these dysregulations in F1 rats. In-silico, the druglike molecules exhibited stronger binding affinities (−6.2 to −8.5 kcal/mol) for the androgen receptor than BPA (−6.1 kcal/mol) within the binding pockets. We postulated that CMSO mitigates transgenerational sperm indices and male fertility hormone disruption in F1 male offspring following F0 male exposure to BPA perhaps by utilizing androgen receptor signaling.

High fibrinogen content in pregnant women – pathology or overdiagnosis?

An increased fibrinogen (FG) concentration during pregnancy is considered a protective mechanism against bleeding during childbirth. An enlarged amount of FG increases the aggregation of erythrocytes, blood plasma viscosity, microvascular resistance – permanent elements of the pathogenesis of arterial hypertension, stroke, coronary heart disease. It is also associated with an increased likelihood of development of preeclampsia and stroke with subsequent neurological disorders.In addition to its undeniable importance for hemostasis, FG is directly related to several physiological and pathophysiological conditions, such as infection, wound healing, tumorigenesis, and the severity of atherosclerosis. It also has a decisive role in the development of pregnancy. Maternal FG is necessary for the progress of pregnancy, as it stabilizes the utero-placental connection at the fibrinoid layer of the fetal-maternal junction. No reports on the study of pathological forms of FG in Ukraine were found.The objective: to compare the indicators of FG concentration and related elements of the blood coagulation system of pregnant and parturient women in different gestational periods and after childbirth.Materials and methods. Blood components from the ulnar vein of 30 women in labor at a gestation period of 22–27 weeks (extremely preterm birth (EPB) – I group), 37 women in labor at a term of 28–34 weeks (early preterm birth (PB) – II group) and 40 women with gestational period 37–41 weeks (control group (CG) – III group) was studied. In the collected samples the content of FG, D-dimer (Dd), prothrombin index (PI), activated partial thromboplastin time (APTT), as well as the levels of hemoglobin (Hb), hematocrit (Ht) and total protein (TP) of the blood plasma were determined.All women in labor were hospitalized in the active phase of the I labor period and did not receive infusion therapy. In terms of gestation, corresponding to EPB, early PB and CG, 10 pregnant women who were on outpatient registration at the Perinatal Center were examined for comparison of the studied indicators outside of labor.Indicators of the biochemical coagulogram were studied on a Helena C-2 semi-automatic coagulometer (Helena Biosciences, Great Britain).Results. The FG concentration increased from 4.2±0.56 g/l in the term 22–27 weeks to 4.4±0.57 g/l before delivery with a diapason of 3.5 to 5.0 g/l. In all parturients, the FG concentration was lower than 4.5 g/l, respectively by group: 4.5±0.81; 4.1±0.74 and 4.1±0.65 g/l (р&lt;0.05). In 24 hours after delivery the FG concentration increased in CG to 5.0±0.82 g/l, and after 48 hours – to 5.3±1.19 g/l, which exceeded the indicators of parturients of the EPB and early PB groups and pregnant women of these same terms, in which the highest indicator was 4.5±0.81 g/l in the EPB group (p&lt;0.05).An increase in the Dd index with growing gestational age was observed in all pregnant women (from 274±133.3 to 501±174.7 μg/l). It continued during the first postpartum day – up to 685±157.5 μg/l, decreased on the second day – 429±198.9 μg/l (p&lt;0.05), approaching the indicators of the EPB and early PB groups (487±267.0 and 397±202.3 μg/l; p&gt;0.05) and pregnant women of the same term.Hb decreased to 106±8.9 g/l, and Ht – to 35±6.1% with the progression of pregnancy. In parturients of the PB group, they were probably higher than the indicators of pregnant women of the corresponding terms, increasing on the second day after delivery – 110±6.7 g/l and 41±3.1%.There was no significant blood loss in the clinical groups. In all pregnant and parturient women the APTT and PI indicators varied from 27.0±3.51 s to 35.4±3.43 s and from 88±4.8% to 101±5.2%, respectively.Conclusions. 1. A gradual increase in the fibrinogen (FG) concentration with increasing gestational age from 4.2±0.56 g/l in 22–27 weeks to 4.4±0.57 g/l by the time of delivery indicates an increase in the level of FG in healthy pregnant women as an adaptive response of the body to the formation of an additional vascular system.2. An excessive FG increase is a consequence of hemoconcentration, not absolute hyperfibrinogenemia, and may be a sign of pathological processes underlying hypovolemia. In case of extremely preterm birth (EPB), the concentration of FG in the parturient was 4.5±0.81 g/l. Higher values of FG, hemoglobin, and hematocrit in parturients with EPB than in pregnant women at the same term are evidence of insufficient hemodilution, which can be considered as one of the pathogenetic mechanisms of premature labor.3. Laboratory indicators of the blood coagulation system – APTT, PI – in the absence of bleeding have no diagnostic value.

The prevalence of inflammatory process in placentas from premature births in different gestational periods

Premature birth (PB) is the birth in less than 37 weeks, which can be spontaneous and iatrogenic, its frequency reaches 10% of all births. The pathogenesis of premature labor is based on the inflammatory reaction of the chorion, amnion and decidual membrane, but the origin of the inflammatory reaction is different depending on the gestational age.The objective: to study the prevalence of the inflammatory response in placenta samples from very early preterm, early preterm and term births.Materials and methods. Placenta samples from 203 parturient women who gave birth in the gestational period of 22–27 weeks – very early PB (I group – 101 parturient women with premature rupture of membranes (PROM), II group – 102 parturient women with the onset of labor with intact membranes) and 202 parturient women were examined with deliveries in the period of 28–34 weeks – early PB (III group – 100 women in labor with PROM and IV group – 102 women in labor with the onset of labor with intact fetal membranes) and 60 women in labor with term deliveries.Immunohistochemical detection of CD8, CD3 and CD14 antigens in villi was used to assess the prevalence of the inflammatory process and compare it between groups.Results. In 56.7% of placentas from term deliveries no markers of villousitis were detected, a mild form of villousitis was found in another third of cases. In placentas of woman with the onset of labor between the 28th and 34th weeks with intact fetal membranes there were signs of villousitis in 54.9%, and its mild manifestations in 33.3%. In the case of premature rupture of the membranes, the prevalence of villousitis reached 65%, its severe forms were more often observed.On the other hand, in the groups of very early PB only 14.9 and 15.7% of placentas had no signs of vilouisitis, one in five placentas from these groups had severe focal or diffuse villousitis. In the group of early PB and intact amniotic membranes, one third of the placentas demonstrated an isolated CD3 lymphocyte marker, no antigen was detected in 47.1% of placentas, and only in every tenth placenta antigens of macrophages of fetal origin were determined. A similar distribution was found in placentas from early PB with PROM.In placentas from very early PB the highest frequency of CD14 detection was found – every second placenta contained this marker in isolation and in 22.5% – in combination with maternal lymphocyte markers. In the group of very early PB on the background of PROM placentas with a positive CD14 test dominated – 31.7% isolated and 45.5% in combination with CD3.Conclusions. 1. In placentas from premature births (PB) at 28–34 weeks, villousitis was detected in 54.9% of cases against the background of intact amniotic membranes and in 65.0% – on the background of premature rupture of the membranes, from very early PBs – in 85.1% and 83.3%, respectively. Placentas from deliveries with premature rupture of the fetal membranes more often had signs of severe villousitis – in 21% of cases at 28–34 weeks and in 20.6% at 22–27 weeks.2. In placentas from early PB, macrophage antigen of fetal origin was detected in 22% of cases in the cases of premature rupture of the fetal membranes and in 21.6% of cases of childbirth with intact membranes; these samples were dominated by infiltration by lymphocytes of maternal origin. On the other hand, placentas from very early PB and ruptured fetal membranes in 77.2% of cases contained antigen of fetal macrophages and in 71.6% of cases of onset of labor with intact membranes.Such results indicate the fetal origin of the inflammatory process in very early PB.

The current state of the problem, clinical-pathogenetic approaches to the diagnosis and management tactics of fetal growth restriction

Fetal growth restriction is a common complication of pregnancy with a complex etiology and limited possibilities of diagnosis and treatment. The relevance of this difficult obstetric problem is determined by various published diagnostic criteria, relatively low detection rates, and limited options for prevention and treatment.Fetal growth restriction is defined as the inability of the fetus to reach its genetically determined growth potential, most often due to abnormal placentation. Forms of fetal growth restriction with early or late onset are distinguished based on the gestational age determined during prenatal ultrasound diagnosis. According to most recommendations, the 32nd week of pregnancy is set as the cut-off point for distinguishing between early and late onset fetal growth restriction.The definition underlying this classification is based on differences between these two phenotypes of fetal growth restriction in severity, natural history, Doppler findings, association with hypertensive complications, placental features, and management. It is important to distinguish two separate conditions: fetal growth restriction and small-for-gestational fetus, which differ in short-term and long-term perinatal outcomes.A fetus is defined as small for gestational age if the estimated weight or weight of the fetus at birth is below the 10th percentile. Fetal growth restriction is diagnosed if the estimated fetal weight is below the 3rd percentile or a combination of pathological blood flow in the umbilical arteries and/or uterine arteries in fetuses with an estimated weight below the 10th percentile. It can also occur in fetuses and newborns with a body weight above the 10th percentile.The need to distinguish between fetal growth restriction and small-for-gestational-age fetus is related to the fact that fetal growth restriction is the main cause of stillbirth, neonatal death, higher perinatal morbidity, as well as increased risk of diseases in adulthood.The article analyzes the approaches to differentiating fetal growth restriction from small growth retardation in terms of fetal gestation period and further increasing the accuracy of diagnosis, as well as the modern concept of pathogenesis, with an emphasis on oxidant stress as a key molecular mechanism of adverse outcomes. Appropriate interventions during pregnancy to reduce perinatal complications should include antenatal monitoring and drug therapy.

How do maternal socioeconomic and behavioral patterns affect oral health in early childhood?

A prospective longitudinal observational cohort study. The data analyzed were derived from a comprehensive observational study on BRISA prenatal cohort conducted in São Luís City, Brazil, between 2010 and 2013. A convenience sample included pregnant women recruited from both public and private prenatal health services in the city. To participate in the study, women needed to have undergone an obstetric ultrasound before the 20th week of pregnancy to estimate gestational age. Multiple pregnancies were excluded. Initially, the pregnant women were interviewed and assessed for oral health indicators between the 22nd and 25th weeks of pregnancy. A follow-up interview was conducted within 48 h after delivery. In the child's second year, the mothers were re-interviewed, and the children were examined for the second follow-up. The study received approval from the local ethics committee, and written informed consent was obtained from all participants. The research followed the STROBE guidelines for reporting observational studies. At baseline, a structured questionnaire was used to gather sociodemographic and lifestyle information like maternal age, family income, education level, occupation of the family head, pre-gestational BMI, alcohol and soft drink consumption, and smoking status during pregnancy. Dental examinations were conducted by 6 trained and calibrated dentists who assessed DMFT index and periodontal health indicators. In the second follow-up, children's oral health was evaluated using visible plaque index (VPI), gingival bleeding, and the modified dmft index. Children's weight and height were measured by a digital scale, and BMI z-scores were calculated based on WHO standards. Sugar-sweetened beverage intake was categorized by terciles based on the percentage of total daily energy from these beverages. Structural equation modeling (SEM) was used to analyze multiple pathways among a set of latent and observed variables. Three latent variables were proposed and measured: Socioeconomic Status and Periodontal Maternal Status in the mothers, and Chronic Oral Disease Burden (CODB) in the children. CODB was inferred from 3 observed indicators: VPI, gingival bleeding, and tooth decay. Total, direct, and indirect effects were calculated for variables from the gestational period and the child's second year of life. In total, 1141 mother-child dyads were included. Periodontal Maternal Status correlated with more decayed teeth in pregnant women (standardized coefficient (SC) = 0.089; p = 0.008). Addictive risk behaviors were highly correlated, with SCs of 0.679 (p < 0.001) for alcohol and smoking, and 0.262 (p < 0.001) for soft drink and alcohol consumption. Obesity (SC = 0.081; p = 0.048) and added sugar consumption (SC = 0.142; p = 0.040) were interconnected across generations from pregnant women to their offspring. Children's consumption of sugar was strongly associated with CODB (SC = 0.357; p = 0.005). Caries and periodontitis were correlated in pregnant women. Obesity and sugar consumption have intergenerational impacts. Early sugar intake relates to CODB in early childhood. Intergenerational behavioral risks affect oral health in the first 1000 days of life, influencing long-term health outcomes.

Do concentrations of non-esterified fatty acids change during gestation and lactation in healthy bitches?

During the gestation and lactation period, the energy demand in pregnant and lactating bitches is elevated. Non-esterified fatty acids (NEFAs) are utilized either directly from the fed diet or from body fat storage. High NEFA concentration in the blood plasma leads to an increased risk for diseases. Therefore, measuring blood NEFA concentrations may be an indicator for a period of scarcity. The aim of this study is to explore if serum NEFA concentrations in healthy bitches change during gestation and lactation. Healthy pregnant and lactating bitches were sampled on three appointed dates around parturition. NEFA values were examined with a multiparameter clinical chemistry analyser. All statistical analyses were performed using R. Overall, 38 bitches were enrolled in the study. Twenty-one bitches were sampled on all three appointed dates. The median NEFA concentration antepartum was 0.73 mmol/L (IQR: 0.59, 1.01); during peak lactation, it was 0.57 mmol/L (IQR: 0.44, 0.82); and around weaning, it was 0.58 mmol/L (IQR: 0.46, 0.73). NEFA concentrations rose slightly with litter size in late gestation. Body condition score had no influence on observed NEFA values. We conclude that NEFA concentrations widely remain within reference ranges in well-fed pregnant and lactating bitches. Nevertheless, they may be a valuable parameter to assess the actual metabolic status of malnourished pregnant and lactating bitches.

A simple and efficient electrochemical sensor for folic acid determination on Ti(OH)4 modified carbon paste electrode

Folic acid (FA) has a crucial function in pregnant women and anemic patients. Having adequate FA prior to and during the gestation period can protect the brain of the child and spine from significant birth abnormalities. It reduces the risk of stroke, heart disease and some types of cancers, etc. Thus, FA is employed as a reliable biomarker in the early identification of various disorders. In the present study, we synthesized titanium tetra hydroxide [Ti(OH)4] nanoparticles (NPs) by precipitation method with annealing at 100 °C, which is used to modify carbon paste electrode (Ti(OH)4 /MCPE). FA is detected here by voltammetry method using Ti(OH)4/MCPE in the phosphate buffer of pH 6 and compared with bare and TiO2-400, TiO2-600 and TiO2-800 °C NPs MCPE. Based on ac-impedance spectra, the conductivity of Ti(OH)4/MCPE was found to be higher, and consequently this electrode showed excellent sensitivity of 5.5 µA µM−1 cm−2. Lower detection limit (1.3 nM) was observed in the concentration range of 0.4–30 μM by differential pulse voltammetry. The Ti(OH)4/MCPE was also effective for the determination of FA in real samples such as orange, banana, spinach and tablet. The electrochemical sensor investigated here showed excellent stability (92 %) up to 30 days.

Developmental exposure to arsenic reduces anxiety levels and leads to a depressive-like behavior in female offspring rats: Molecular changes in the prefrontal cortex

Exposure to inorganic arsenic (iAs) detrimentally affects the structure and function of the central nervous system. In-utero and postnatal exposure to iAs has been connected to adverse effects on cognitive development. Therefore, this investigation explores neurobehavioral and neurochemical effects of 0.05 and 0.10 mg/L iAs exposure during gestation and lactation periods on 90-day-old female offspring rats. The assessment of anxiety- and depressive-like behaviors was conducted through the application of an elevated plus maze and a forced swim test. The neurochemical changes were evaluated in the prefrontal cortex (PFC) through the determination of enzyme activities and α1 GABAA subunit expression levels. Our findings revealed a notable impact of iAs exposure on anxiety and the induction of depressive-like behavior in 90-day-old female offspring. Furthermore, the antioxidant status within the PFC exhibited discernible alterations in exposed rats. Notably, the activities of acetylcholinesterase and glutamate pyruvate transaminase demonstrated an increase, while glutamate oxaloacetate transaminase activity displayed a decrease within the PFC due to the iAs treatment. Additionally, a distinct downregulation in the mRNA expression of the α1GABAA receptor was observed in this neuronal region. These findings strongly suggest that iAs exposure during early stages of rat development causes significant modifications in brain oxidative stress markers and perturbs the activity of enzymes associated with cholinergic and glutamatergic systems. In parallel, it elicits a discernible reduction in the level of GABA receptors within the PFC. These molecular alterations may play a role in the diminished anxiety levels and the depressive-like behavior outlined in the current investigation.

Determination of the rat estrous cycle vased on EfficientNet.

In the field of biomedical research, rats are widely used as experimental animals due to their short gestation period and strong reproductive ability. Accurate monitoring of the estrous cycle is crucial for the success of experiments. Traditional methods are time-consuming and rely on the subjective judgment of professionals, which limits the efficiency and accuracy of experiments. This study proposes an EfficientNet model to automate the recognition of the estrous cycle of female rats using deep learning techniques. The model optimizes performance through systematic scaling of the network depth, width, and image resolution. A large dataset of physiological data from female rats was used for training and validation. The improved EfficientNet model effectively recognized different stages of the estrous cycle. The model demonstrated high-precision feature capture and significantly improved recognition accuracy compared to conventional methods. The proposed technique enhances experimental efficiency and reduces human error in recognizing the estrous cycle. This study highlights the potential of deep learning to optimize data processing and achieve high-precision recognition in biomedical research. Future work should focus on further validation with larger datasets and integration into experimental workflows.

Comparison of sonographic score and Bishop score in the prediction of successful labor induction in term patients: A prospective observational study

BackgroundThe cervical favorability for IOL is assessed by scoring systems. There are various scoring systems, including the Field system, Lange pelvic scoring system, and Bishop scoring system, which was then modified and termed ‘The modified Bishop scoring system, and it is the most widely used one. This scoring is done based on the assessment of the station of the fetal presenting part, consistency, position, dilatation, and length of the maternal cervix. Owing to its subjective assessment, there is a high chance of inter-observer variability. Therefore, radiological methods such as Trans-vaginal ultrasonogram (TVS) and Trans-abdominal ultrasonogram (TAS) are preferred over manual methods. This study aims to determine the role of assessment of the cervix by Modified Bishop Score and assessment of the cervical parameters by Transvaginal ultrasonogram (TVS) and compare them in predicting the outcome of labour. Material and methodsThis prospective observational study was conducted by the Department of Obstetrics and Gynecology in a tertiary care hospital located at Chengalpattu, Tamil Nadu, in a term singleton pregnancy woman, and the Study period was from January 2023 to July 2023 for six months. In total, one hundred fifty pregnant women were recruited. The study inclusion criteria were singleton pregnant women with intact amniotic membranes and a period of gestation >37 weeks with cephalic presentation. The findings of TVS were blinded to the person who measured cervical parameters for the bishop score. IOL done for both favorable and unfavorable cervix according to the guidelines given by FOGSI-ICOG (2018) for IOL. ResultsReceiver operating characteristic (ROC) curve analysis showed the area under the curve (AUC) for the TVS score was 0.705(95 % CI: 0.616–0.794) against the standard bishop score. TVS Score≥6.5 cm is the best cut-off value to ascertain successful IOL with a sensitivity of 99 % and specificity of 94 % among singleton pregnancy women. ConclusionThis prospective observational study deduced that TVS scoring is a valid alternative tool against the standard bishop score in predicting cervical favorability for IOL among singleton pregnant women with plausible sensitivity and specificity. TVS scoring for assessing cervical favorability acts as an outstanding marker in predicting the IOL with a cut-off value of ≥6.5 cm in singleton pregnant women.

Formation of the Mandibular Condylar Cartilage in Human Specimens Between 10 and 15 Weeks of Gestation

Background: The study examines some morphological and histological factors that may contribute to condylar cartilage (CC) formation. The specimens used were consecutive sections obtained from 20 human fetuses ranging in age from 10 to 15 weeks. The vascular canals (VC) emerge in the CC and initiate the process of intramembranous ossification. The mandibular condylar cartilage is crucial for the growth and function of the mandible, and it also contributes to the development of the Temporomandibular joint. Understanding the development of mandibular condylar cartilage throughout the early stages of gestation is essential for detecting congenital craniofacial deformities. Objectives: Examine the stages of MCC development in human samples from fetuses at 10-15 weeks of gestation. Study Design: A descriptive Cross-sectional Study. Place and Duration of Study: Department of Anatomy and Obstetric Nowshera Medical College from 15th Nov 2020 to 1st Jun 2021. The changes in the shape and size of the bones and the processes of bone formation should also be determined. Methods: The current study is descriptive, cross-sectional, and involves post-mortem human fetal specimens aged 10-15 weeks. The specimens were obtained from the Department of Obstetrics of QHAMC after miscarriages and intrauterine deaths. The absence of external and congenital malformations was verified. Light microscopic and histological assessment was done with the aid of H&amp;E-stained sections. Results : Twenty fetal specimens were used in the study, with an average gestation period of 12. 5 weeks (±1. 5 weeks). Histological analysis revealed gradual chondrocyte maturation and the beginning of the ossification process. At ten weeks, MCC was comprised of undifferentiated mesenchymal cells. At twelve weeks, it is possible to observe the differentiation of chondrocytes and early ossification. At 15 weeks, the ossification stages of the CRL were at a superior level with the hypertrophic chondrocytes and mineralized cartilage. The p-values for differences in developmental stages between the gestational ages were less than 0. Hence, the differences were statistically significant. Conclusion: The MCC in human specimens at 10–15 weeks' gestation undergoes considerable morphological transformation and commences the ossification process. Knowledge of these stages is essential in identifying and intervening in congenital craniofacial disorders. The authors recommend that future studies focus on investigating molecular processes that may contribute to the development of MCC. Keywords: Mandibular condylar cartilage, Development, Gestation, Ossification

Changes in cerebral hemodynamics after week 32 of gestation in fetuses with late-onset fetal growth restriction

BACKGROUND: Late-onset fetal growth restriction is characterized by changes in fetal cerebral hemodynamic patterns. Blood flow parameters in the anterior, middle, and posterior cerebral arteries have been studied previously, and there was shown a relationship between changes in certain cerebral artery vascular resistance parameters and increased risk of adverse perinatal outcomes such as fetal hypoxia in labor, cesarean section, and stillbirth. AIM: The aim of this study was to search for cerebral hemodynamic patterns in fetuses with late-onset fetal growth restriction after week 32 of gestation. MATERIALS AND METHODS: This prospective study included 110 pregnant women at week 32 or more of gestation who underwent fetal ultrasound (fetometry and Doppler with additional measurement of vascular resistance parameters in the anterior and posterior cerebral arteries). Ultrasound findings were assessed for the presence of late-onset fetal growth restriction. The systole-diastolic ratio, resistance index, and pulsatility index were evaluated in appropriate-for-gestational-age fetuses and in fetuses with late-onset fetal growth restriction. RESULTS: A total of 128 middle, 86 anterior, and 87 posterior cerebral arteries measurements were included in the calculations. From weeks 32–33 to preterm gestation in appropriate-for-gestational-age fetuses, a decrease in the middle cerebral artery parameters was observed, while in the anterior and posterior cerebral arteries, the vascular resistance parameters remained at the same level or slightly increased. A nonlinear trend of blood flow changes in the anterior and posterior cerebral arteries was observed in fetuses with fetal growth restriction — the values increased by weeks 34–36 of gestation and decreased in preterm gestation. At the same time, differences (р 0.05) were found between the median values of the systolic-diastolic ratio, resistance index and pulsatility index in the anterior and posterior cerebral arteries at weeks 34–36 and those at preterm gestation. CONCLUSIONS: Changes in fetal cerebral hemodynamics in fetal growth restriction, in particular, a shift in the peak values of vascular resistance parameters to later gestational periods may be associated with changes in the development of integrative functions of the central nervous system and neurovascular development of the fetal brain (cortex), which occurs predominantly in the third trimester of pregnancy.

The state of female reproductive health in a city with a large petrochemical complex

Introduction. The demographic situation in the country is characterized by a natural decline in the population, which determines the special importance of the protection of motherhood and childhood. The system of obstetrics largely affects the health status of the population and the future generation. Therefore, the study of the state of obstetrics has a high social significance and is relevant. Purpose of the study. To assess the state of female reproductive health of the population living in a city with a large petrochemical complex. Materials and methods. An analysis of primary digital data characterizing the intensive and extensive indicators of the state of obstetric care in the city of Salavat for 2020 was performed. According to the report of the Ministry of Health of the Republic of Bashkortostan “The state of health of the population and the activities of medical institutions of the Republic of Bashkortostan in 2020” a comparative analysis was carried out. Results. An analysis of the state of obstetric care in the city of Salavat showed that women began to give birth less, they interrupted one third of the onset of pregnancies with abortions. The number of abortions per 1,000 women of childbearing age is 1.5 times higher than in the republic. Over the years, the number of abortions is growing against the background of their decline in the republic. Women who wish to give birth in the vast majority come under the supervision of an antenatal clinic until the 12-week gestation period. The results of the course of pregnancy, childbirth, and the postpartum period, the absence of maternal mortality indicate to a high level of obstetric care. However, he draws attention to the fact that 45.6±1.5% of deliveries and the postpartum period proceeded against the background of complications, among which the most significant were anemia, premature rupture of the amniotic membrane, and violations of labour activity. Every third woman in labour underwent a caesarean section, every fifth - vacuum extraction. The health indicators of the fetus and newborn in the trend in years are improving and more favourable than in the republic as a whole, but 58.9±1.3% of neonates were born sick and fell ill. Mainly in the form of asphyxia during childbirth (18.6±1.2%) and infectious diseases (39.5±4.4%). Preterm infants get sick 2 times more often than full-term ones and the main reason is asphyxia during delivery and respiratory disorders over the perinatal period. Limitations. The analysis of the primary digital values of obstetric care indicators of the forms of federal statistical observation and accounting of medical institutions in Salavat for 2020 was carried out. Conclusion. More favourable health indicators of pregnant women, mothers, fetuses in Salavat in comparison with republican and all-Russian ones indicate to the high-quality, qualified obstetric care. The higher incidence of respiratory diseases in infants during the first year of life living in a city of large petrochemistry determines the need for special in-depth studies.

Harnessing the role of nutrigenomics for feed efficiency utilization in cattle: Opportunities and challenges

Nutrigenomics, the study of the interaction between nutrition and genes, presents a transformative approach to enhancing feed efficiency in cattle. This field leverages genetic insights to optimize dietary formulations, aiming to improve nutrient utilization and overall productivity. With the global demand for meat and dairy products rising, increasing feed efficiency is critical for economic viability and environmental sustainability in the livestock industry. The role of nutrigenomics in cattle feed efficiency encompasses several key areas. Precision nutrition is one of the foremost opportunities, enabling the design of diets tailored to the genetic profiles of individual animals. This personalized approach can significantly enhance nutrient absorption and reduce feed costs. Additionally, nutrigenomics can inform selective breeding programs, identifying genetic markers associated with superior feed efficiency traits. By breeding cattle with these desirable traits, farmers can achieve herds that require less feed to produce the same amount of meat or milk, thereby improving profitability and reducing environmental impact. The gestation period in cattle, typically around 283 days, is critical for breeding management. Proper timing ensures optimal calving intervals and productivity. Monitoring gestation aids in anticipating calving dates, ensuring adequate nutrition, health care, and minimizing complications, thereby enhancing overall herd fertility and efficiency. However, the implementation of nutrigenomics faces several challenges. Practical challenges include integrating genetic data into everyday farming practices and ensuring farmers are adequately trained. Ethical and regulatory concerns also arise, particularly regarding genetic modifications and the acceptance of such technologies by consumers and regulators. Moreover, initial investments in nutrigenomic technologies and potential market barriers may hinder widespread adoption. Current research and case studies demonstrate the potential of nutrigenomics to revolutionize cattle feed efficiency. Successful applications in various regions highlight both the feasibility and benefits of this approach. Future advancements in genomic technologies, coupled with collaborative efforts between industry and academia, are expected to overcome existing challenges. Policy support and funding will be crucial in facilitating this transition. Harnessing nutrigenomics for feed efficiency in cattle offers promising opportunities but requires addressing significant challenges. The integration of genetic insights into nutrition and breeding practices stands to enhance livestock productivity, economic gains, and environmental sustainability, paving the way for a more efficient and sustainable livestock industry. Keywords: Nutrigenomics, Feed efficiency, Genetic markers, Cattles,

Association of mRNA expression and polymorphism of antioxidant glutathione-S-transferase (GSTM1 and GSTT1) genes with the risk of Gestational Diabetes Mellitus (GDM)

Gestational Diabetes Mellitus (GDM) is a medical complication during the gestational period in which woman who had never been diagnosed with diabetes develops hyperglycemia. Prior studies have demonstrated that the advancement of GDM and its consequences arises from a disparity between oxidants and antioxidants in the cells. The observed outcomes can be attributed to an excessive formation of reactive oxygen species (ROS) within the cells, coupled with a reduced activity of anti-oxidative enzymes. Glutathione S-transferase (GSTs) is recognized as an antioxidant enzyme that is belong to as a phase II family member of detoxifying enzymes. These metabolic multigene catalysts are found into the cytoplasm of the cell. GSTs play a vital part in the elimination of cellular ROS or free radicals. The study involves total 300 pregnant women, (150 GDM cases and 150 healthy controls). The polymorphism study of GSTs genes (GSTM1 and GSTT1) was determined by conventional Polymerase Chain Reaction (PCR). The mRNA expression study of GSTM1 and GSTT1 genes analysed by qPCR/ RT-PCR (quantitative PCR/Real-Time PCR) followed by statistical analysis done using Prism8 software (version 8.01). The study revealed statistically significant variations in biochemical parameters between GDM cases and controls. It was found GSTM1-null (GSTM1-/-) polymorphism significantly (P < 0.0001) most prevalent in GDM cases (56.7%) when compared to healthy control (28%). However, no significant difference was observed for GSTT1 null and present polymorphism (P = 0.906). The gene expression levels of both GSTM1 and GSTT1 were found considerably downregulated in individuals with GDM as compared to the control group (P < 0.0001). The downregulation of gene expression has a significant (P<0.0001) association with the null/deletion polymorphism of both GSTM1/ GSTT1 genes respectively. Null/deletion genotype of GSTM1 gene and its expression showed significant association with GDM. Therefore, this gene variant has the potential to be used as a prognostic biomarker for GDM. However, there is need to study this gene variant in larger sample size and different ethnicity.

Determination of Rhythmicity and Gestational Stage-Related Distribution of Blood Plasma Melatonin Concentrations in Donkey Mares.

The aim of this study is to obtain a more complete picture of blood plasma melatonin concentrations in the donkey mares. To this purpose, sampling and statistical processing were carried out in such a way that allowed the researchers to establish the annual and daily rhythms. Based on human observations, according to the hypothesis of the authors, the blood plasma melatonin concentration of pregnant individuals rises during the late gestational period, before parturition. To confirm this, the melatonin concentrations of pregnant and non-pregnant jennies were monitored and compared. In regard to the circannual rhythm, the significantly lowest midnight melatonin value (27.67 pg mL-1) was typical for the summer solstice. Under consideration of circadian changes, a significantly strongest melatonin production (45.16 pg mL-1) was observed on the night of the winter solstice (p < 0.001). Considering gestational age, the blood plasma melatonin concentration (around 38 pg mL-1) does not change as gestation progresses (p = 0.136). The results obtained in this studied population of the domestic ass usefully expand the little knowledge previously gathered about the development of the blood plasma melatonin concentrations of this species.

Scientific production about the influence of health literacy during the gestational period

Introduction: Health literacy is crucial for pregnant women's ability to access, understand, and use health information. Objeivo: to assess its impact on the quality of care during pregnancy. Method: An integrative review was conducted using LILACS, MEDLINE, and BDENF databases. Results: highlighted the influence of inadequate health literacy on prenatal care and interventions promoting health literacy during pregnancy. Conclusion: Healthcare professionals must recognize and address health literacy challenges in pregnant women to enhance care quality. Strategies focusing on health literacy promotion can empower individuals, promote awareness, and improve healthcare outcomes during pregnancy.