Pregnancy Complications In Women Research Articles

Triple-Responsive, Multimodal, Visual Electronic Skin toward All-in-One Health Management for Gestational Diabetes Mellitus.

Gestational diabetes mellitus (GDM) is one of the most common metabolic disorders during pregnancy, leading to serious complications for pregnant women and a threat to life safety of infants. Therefore, it is particularly important to establish a multipurpose monitoring pathway to important physiological indicators of pregnant women. In this work, three kinds of double network hydrogels are prepared with poly(vinyl alcohol) (PVA), borax, and cellulose ethers with varying substituents of methyl (methyl cellulose, MC), hydroxypropyl (hydroxypropyl cellulose, HPC), or both (hydroxypropyl methyl cellulose, HPMC), respectively. The corresponding toughness (143.9, 102.3, and 135.9 kJ cm-3) and conductivity (0.69, 0.45, and 0.51 S m-1) of the hydrogels demonstrate that PB-MC was endowed with the prominent performance. Molecular dynamics simulations further revealed the essence that hydrogen bond interactions between PVA and cellulose ethers play a critical role in regulating the structure and properties of hydrogels. Thermochromic capsule powders (TCPs) were subsequently doped in to achieve a composite hydrogel (TCPs@PB-MC) to indicate the change in human body temperature. Furthermore, the process of the TCPs@PB-MC response to glucose, pH, and temperature was tracked in-depth through the electrochemical window. This work provides a novel strategy for all-in-one health management of GDM.

EDUKASI GIZI DAN MINUMAN KACANG HIJAU SEBAGAI PREVENTIF ANEMIA DALAM KEHAMILAN

In developing countries, the most common pregnancy complication in pregnant women is anemia. The prevalence of anemia in pregnancy in Indonesia is still quite high, including in the East Java region. The problem of pregnant women at the Polindes Kaliwining in the Puskesmas Rambipuji Jember is that anemia status is not detected in each trimester of pregnancy. Mung beans contain iron which helps the formation of erythrocytes to increase hemoglobin levels. This community service aims to provide nutritional education and the use of mung beans in preventing anemia in pregnancy. The implementation of this service uses an outreach method using a video media approach. Apart from that, blood hemoglobin levels are also checked in pregnant women as an early detection of anemia. Iron supplementation is given in the form of blood supplement tablets to pregnant women. Furthermore, giving mung beans drinks as a complement to iron supplementation to prevent anemia in pregnancy. The educational approach via video has proven effective in increasing pregnant women's knowledge by 25% regarding anemia and the benefits of mung beans. Based on the results of examinations during this service activity, blood hemoglobin levels showed that 2 respondents experienced anemia in the third trimester of pregnancy. Regular Hb checks are very important during pregnancy. The combination of consuming blood supplement tablets and mung beans can reduce the incidence of anemia in pregnancy.

Acute Pancreatitis in Pregnancy: A Propensity Score Matching Analysis and Dynamic Nomogram for Risk Assessment.

Acute pancreatitis is easily confused with abdominal pain symptoms, and it could lead to serious complications for pregnant women and fetus, the mortality was as high as 3.3% and 11.6-18.7%, respectively. However, there is still lack of sensitive laboratory markers for early diagnosis of APIP and authoritative guidelines to guide treatment. The purpose of this study was to explore the risk factors of acute pancreatitis in pregnancy, establish, and evaluate the dynamic prediction model of risk factors in acute pancreatitis in pregnancy patients. Clinical data of APIP patients and non-pregnant acute pancreases patients who underwent regular antenatal check-ups during the same period were collected. The dataset after propensity matching was randomly divided into training set and verification set at a ratio of 7:3. The model was constructed using Logistic regression, least absolute shrinkage and selection operator regression, R language and other methods. The training set model was used to construct the diagnostic nomogram model and the validation set was used to validate the model. Finally, the accuracy and clinical practicability of the model were evaluated. A total of 111 APIP were included. In all APIP patients, hyperlipidemic pancreatitis was the most important reason. The levels of serum amylase, creatinine, albumin, triglyceride, high-density lipoprotein cholesterol, and apolipoprotein A1 were significantly different between the two groups. The propensity matching method was used to match pregnant pancreatitis patients and pregnant non-pancreatic patients 1:1 according to age and gestational age, and the matching tolerance was 0.02. The multivariate logistic regression analysis of training set showed that diabetes, triglyceride, Body Mass Index, white blood cell, and C-reactive protein were identified and entered the dynamic nomogram. The area under the ROC curve of the training set was 0.942 and in validation set was 0.842. The calibration curve showed good predictive in training set, and the calibration performance in the validation set was acceptable. The calibration curve showed the consistency between the nomogram model and the actual probability. The dynamic nomogram model we constructed to predict the risk factors of acute pancreatitis in pregnancy has high accuracy, discrimination, and clinical practicability.

العلاقة بين سمية الفلوريد والإجهاد التأكسدي ومضاعفات الحمل لدى النساء اللواتي يعشن في مناطق التسمم بالفلور

كان الهدف من هذه الدراسة هو التحقيق من العلاقة بين مستويات فلوريد البلازما المرتفعة، والإجهاد التأكسدي، ومضاعفات الحمل (الإجهاض، وموت الجنين داخل الرحم، والولادة المبكرة، وتسمم الحمل) لدى النساء اللواتي يعشن في إقليم سطات بالمغرب. تم جمع عينات الدم من النساء الحوامل ذوات الحمل الطبيعي (عدد = 60)، والإجهاض (عدد = 20)، وموت الجنين داخل الرحم (عدد = 10)، والولادة المبكرة (عدد = 20)، وتسمم الحمل (عدد = 20). بعد ذلك، تم تحديد مستويات فلوريد البلازما والأنشطة الأنزيمية لخلايا الدم الحمراء من superoxide dismutase (SOD)، catalase (CAT)، glutathione peroxidase (GPx). أظهرت النتائج أن مستويات الفلوريد في البلازما أقل بشكل ملحوظ عند النساء ذوات الحمل الطبيعي بتركيز 0.030 ± 0.003 ملغم / لتر مقارنة بالنساء اللائي تعرضن للإجهاض وموت الجنين داخل الرحم والولادة المبكرة وتسمم الحمل، بتركيزات 0.040 ± 0.002، 0.037 ± 0.002، 0.034 ± 0.004 و0.034 ± 0.003 ملغم / لتر، على التوالي. بالإضافة إلى ذلك، زاد نشاط SOD بشكل ملحوظ عند النساء اللواتي يعانين من مضاعفات الحمل، بينما انخفضت أنشطة CAT وGPx مقارنة بالنساء ذوات الحمل الطبيعي. علاوة على ذلك، لوحظ وجود علاقة قوية بين مستويات فلوريد البلازما وأنشطة مضادات الأكسدة ومضاعفات الحمل. قد يؤدي وجود مستويات عالية من فلوريد البلازما إلى زيادة انتشار الإجهاض ووفاة الجنين داخل الرحم والولادة المبكرة وتسمم الحمل، عبر مسار الإجهاد التأكسدي لدى النساء الحوامل اللواتي يعشن في إقليم سطات بالمغرب.

Pathogenetic traits of preeclampsia in COVID-19. A relevant literature review

The aim of this study was to present the latest data on the association of preeclampsia and coronavirus infection and on the preeclampsia-like syndrome, and to analyze the current literature on the pathogenetic relationships between COVID-19 and preeclampsia and on morphological changes in placental tissue in patients with these gestational complications.
 A significant portion of studies indicate an increased risk of developing preeclampsia in patients with coronavirus infection during pregnancy, regardless of gestational age, especially in severe COVID-19, but other researchers report no association between coronavirus infection and the onset of preeclampsia. The supposed pathogenetic connection between these pathologies consists in the development of systemic endothelial dysfunction and dysregulation of the renin-angiotensin-aldosterone system, while the direct effect of SARS-CoV-2 on the placentation is poorly understood and is a subject of debate. A new concept of the so-called “preeclampsia-like syndrome” has been introduced, which presumably occurs in patients with a severe form of the novel coronavirus infection as its extrapulmonary manifestation. The measurement of the ratio of soluble fms-like tyrosine kinase-1 activity to the level of placental growth factor ratio has been proposed as a differential diagnostic test between preeclampsia and the preeclampsia-like syndrome, but its prognostic value remains ambiguous. The morphological examination of placentas in patients with coronavirus infection and preeclampsia indicates the signs of maternal and fetal vascular malperfusion.
 The literature on the association between coronavirus infection and preeclampsia remains controversial, however, the better half of the researchers is indicative of a significant increase in the risk of developing this serious complication in pregnant women with COVID-19, especially for its severe form. New information about the preeclampsia-like syndrome, as well as the virtual absence of studies of placental morphology in patients with preeclampsia and coronavirus infection during pregnancy, dictate the need for further study to better understand the association between these two pathologies, determine the possibilities of patient surveillance and prevent complications.

Hubungan Perilaku Ibu, Peran Nakes, Dan Motivasi Keluarga Terhadap Kejadian Anemia Pada Ibu Hamil Di Desa Permis

Introduction: Anemia in pregnancy is a problem in the health sector because it is an indicator of poor nutritional status and health status. Anemia during pregnancy is defined as Hb less than 10 g/dL. If Hb is below 12 g/dL in early pregnancy, pregnant women may need to be given prophylactic drugs because of hemodilution which reduces Hb levels to less than 10 g/dL. The purpose of this study was to determine the relationship between maternal behavior, the role of health workers, and family motivation on the incidence of anemia in pregnant women in Permis Village in 2022. Methods: This type of research is an analytical descriptive study using a quantitative method with a cross-sectional approach. Results: The statistical test results show that there is a relationship between the role of midwives and the incidence of anemia in pregnant women in Permis Village in 2022 with a p-value of 0.006. there is a relationship between family motivation and the incidence of anemia in pregnant women in Permis Village in 2022 with a p-value of 0,021. there is a relationship between anemia prevention behavior and the incidence of anemia in pregnant women in Permis Village in 2022 with a p-value of 0.013. Discussion: The conclusion is the relationship between maternal behavior, the role of health workers, and family motivation toward the incidence of anemia in pregnant women in Permis Village in 2022. The suggestion for this research is to apply healthy behavior on how to prevent and treat anemia during pregnancy to prevent complications in pregnant women and fetuses.

A qualitative study of pregnant women’s perceptions and decision-making regarding COVID-19 vaccination in Thailand

To identify pregnant women’s attitudes towards, and acceptance and rejection of, COVID-19 vaccination. This prospective, descriptive, implementation study was conducted in the Antenatal clinic of Siriraj Hospital, Bangkok, Thailand. In Phase I, 40 pregnant women were interviewed. Phase II consisted of questionnaire development and data validation. In Phase III, the questionnaire was administered to 400 participants. Pregnant women’s attitudes towards and acceptance and rejection of COVID-19 vaccination. Most pregnant women were uncertain about the potential harm of vaccination to themselves or their unborn child, including risks such as miscarriage or premature birth (59–66/101 [58.4%–65.3%]; OR 2.53–8.33; 95% CI 1.23–3.60, 5.17–19.30; P < 0.001) compared to those who disagreed with vaccination. Their vaccination decisions were significantly influenced by social media information regarding vaccination complications in pregnant women (74/101 [73.3%]; OR 15.95; 95% CI 2.15–118.55; P = 0.001) compared to those who disagreed with vaccination. Most pregnant women opined that they should not receive a COVID-19 vaccination during pregnancy (adjusted odds ratio [AOR] 6.57; 95% CI 2.44–17.70; P = 0.001). Most also rejected vaccination despite being aware of its benefits (AOR 17.14; 95% CI 6.89–42.62; P < 0.001). Social media messages and obligatory vaccination certifications influence maternal vaccination decisions. Pregnant women believe vaccination helps prevent COVID-19 infection and reduces its severity. Nevertheless, the primary reason for their refusal was concern about potential harm to their unborn child or themselves during pregnancy.The Thai clinical trials registry: TCTR20211126006.

Hepatitis E virus infection increases the risk of obstetric complications and perinatal adverse outcomes in pregnant women with chronic hepatitis B virus infection.

Hepatitis E virus (HEV) infection may occur in pregnant women who had chronic hepatitis B virus (HBV) infection. This study aimed to evaluate whether HEV-HBV co-infection increases the risk of obstetric complications and perinatal adverse outcomes in pregnant women. We investigated the clinical data of 3,251 pregnant women with chronic HBV infection. The obstetric complications and perinatal adverse outcomes were compared between patients with HEV-HBV co-infection and patients who had pure chronic HBV infection. Of the 3,251 pregnant women with chronic HBV infection, 98 patients (3%) had HEV-HBV co-infection. Compared with healthy controls, there is an increased risk of obstetric complications in pregnant women with pure HEV infection [odds ratio (OR)= 3.99, p < 0.001], pure chronic HBV infection (OR = 2.76, p < 0.001), and HEV-HBV co-infection (OR = 5.41,p < 0.001). The rate of obstetric complications and perinatal adverse outcomes is significantly higher in pregnant women with HEV-HBV co-infection compared with those with pure chronic HBV infection or those with pure HEV infection (all p< 0.05). The HEV-HBV co-infection is the most significant risk factor for perinatal adverse outcomes (OR = 15.47, p < 0.001), followed by pure HEV infection (OR = 10.22, p < 0.001), and pure HBV infection (OR = 5.82, p < 0.001). HEV infection increases the risk of obstetric complications and perinatal adverse outcomes in pregnant women with chronic HBV infection.

Prediction of pregnancy-related complications in women undergoing assisted reproduction, using machine learning methods

To use machine learning methods to develop prediction models of pregnancy complications in women who conceived with assisted reproductive techniques (ART). A nation-wide register-based cohort study with prospectively collected data. Swedish national registers and nationwide quality IVF register. all nulliparous women who achieved birth within the first 3 ART treatment cycles between 2008 and 2016 in Sweden. Characteristics before the use of ART, such as demographics and medical history, were considered potential predictors in the development of before treatment prediction models. ART treatment details were further included in after treatment prediction models. Potential diagnoses of preeclampsia, placental complications (previa, accreta, and abruption), and postpartum hemorrhage were identified using the International Classification of Diseases recorded in the Swedish Medical Birth and Patient registers, respectively. Multiple prediction model algorithms were performed and compared for each outcome and treatment cycle, including logistic regression, decision tree model, naïve Bayes classification, support vector machine, random forest, and gradient boosting. The performance of each model was assessed with C statistic, and nested cross-validation was used to aid model selection and hyperparameter tuning. A total of 14,732 women gave birth after the first (N = 7,302), second (N = 4,688), or third (N = 2,742) ART cycle, representing birth rates of 24.1%, 23.8%, and 22.0%. Overall prediction performance did not vary much across the different methods used. In the first cycle, the before treatment prediction performance was at best 66%, 66%, and 60% for preeclampsia, placental complications, and postpartum hemorrhage, respectively. Inclusion of after treatment characteristics conferred slight improvement (approximately 1%-5%), as did prediction in later cycles (approximately 1%-5%). The top influential and consistent predictors included age, region of residence, infertility diagnosis, and type of embryo transfer (fresh or frozen) in the later (2nd and 3rd) cycles. Body mass index was a top predictor of preeclampsia and was also influential for placental complications but not for postpartum hemorrhage. The combined use of demographics, medical history, and ART treatment information was not enough to confidently predict serious pregnancy complications in women who conceived with ART. Future studies are needed to assess if additional longitudinal follow-up during pregnancy can improve the prediction to allow clinical protocol development.

Early to mid-pregnancy HbA1c levels and its association with adverse pregnancy outcomes in three low middle-income countries in Asia and Sub-Saharan Africa

BackgroundHyperglycemia during pregnancy leads to adverse maternal and fetal outcomes. Thus, strict monitoring of blood glucose levels is warranted. This study aims to determine the association of early to mid-pregnancy HbA1c levels with the development of pregnancy complications in women from three countries in South Asia and Sub-Saharan Africa.MethodsWe performed a secondary analysis of the AMANHI (Alliance for Maternal and Newborn Health Improvement) cohort, which enrolled 10,001 pregnant women between May 2014 and June 2018 across Sylhet-Bangladesh, Karachi-Pakistan, and Pemba Island-Tanzania. HbA1c assays were performed at enrollment (8 to < 20 gestational weeks), and epidemiological data were collected during 2–3 monthly household visits. The women were followed-up till the postpartum period to determine the pregnancy outcomes. Multivariable logistic regression models assessed the association between elevated HbA1c levels and adverse events while controlling for potential confounders.ResultsA total of 9,510 pregnant women were included in the analysis. The mean HbA1c level at enrollment was found to be the highest in Bangladesh (5.31 ± 0.37), followed by Tanzania (5.22 ± 0.49) and then Pakistan (5.07 ± 0.58). We report 339 stillbirths and 9,039 live births. Among the live births were 892 preterm births, 892 deliveries via cesarean section, and 532 LGA babies. In the multivariate pooled analysis, maternal HbA1c levels of ≥ 6.5 were associated with increased risks of stillbirths (aRR = 6.3, 95% CI = 3.4,11.6); preterm births (aRR = 3.5, 95% CI = 1.8–6.7); and Large for Gestational Age (aRR = 5.5, 95% CI = 2.9–10.6).ConclusionMaternal HbA1c level is an independent risk factor for predicting adverse pregnancy outcomes such as stillbirth, preterm birth, and LGA among women in South Asia and Sub-Saharan Africa. These groups may benefit from early interventional strategies.

Some results of perinatal complications in pregnant women with polycystic ovary syndrome

Purpose. Evaluation of the results of complications in the perinatal period in pregnant women with (PCOS) polycystic ovary syndrome. Material and methods. The research carried out for the accumulation, processing and analysis of data was a retrospective study that was carried out during the years 2020-2022 within IMSP SCM no. 1, the patients were divided into 2 groups: Group I – 60 patients with polycystic ovary syndrome and pregnancy achieved. Group II – 60 patients with normal pregnancy. According to its character, the study carried out is descriptive observational. The method of accumulating and extracting data from the medical documentation did not allow the determination of anamnestic-clinical peculiarities, clinical and paraclinical investigations (laboratory and instrumental), the evolution of the pregnancy and the birth of the pregnant women included in the study, including the assessment of the status of the newborn at birth. Results. From the results of the study, it can be confirmed that there were no statistically significant differences (&gt;0.05) between the 2 groups included in the study. Live children were born - 50 (94.34±0.32) in group I compared to 58 (96.7±0.63) in group II. Neonatal death was registered only in group I – 3 (5.66±0.32) cases and neonatal death only in group II – 2 (3.3±0.63) cases. Conclusion. The results of the comparative study show that pregnancy in pregnant women with PCOS ends with macrosomicfetuses - 26.43%; with an Apgar score of 7-8 in – 38.3%; who did not require transfer to the neonatal intensive care unit – 64%. Strict antenatal monitoring of pregnancy remains the gold standard for favorable perinatal outcomes.

The role of low-molecular-weight heparin on recurrent abortion: a review

Recurrent abortion (RA) remains a significant challenge in gynecological practice. It is not only emotionally devastating for pregnant women but is also medically challenging. RA is the spontaneous loss in the first trimester of three or more consecutive pregnancies. The current review was aimed at investigating the role of low-molecular-weight heparin (LMWH) in RA. The online databases MEDLINE and Google Scholar were used to perform a literature search for publications published between 2015 and 2013, without any date or language restrictions. We used a combination of relevant search terms &amp;quot;role, low, molecular, weight, heparin, recurrent, and abortion.&amp;quot; We independently identified publications and systematically screened titles, abstracts, and full texts of the collected publications. LMWH was found to be used to treat RA due to its anticoagulants and anti-inflammatory effect. Its use is associated with a substantial improvement in live birth rates in most studies reviewed, with a few inconclusive. There was no significant improvement in late pregnancy complications in women treated with LMWH in the control group. Women treated with LMWH experienced very few adverse medication responses, and those that did occur were often moderate and self-limiting, making LMWH therapy a safe option. To create a consensus recommendation on the treatment of RA, further research on the use of LMWH is required, ideally in the form of sizable multicenter randomized control trials.

Prevalence of obstetric complications in pregnant women in Osisioma-NgwaLocal Government Area, (LGA). Abia State, Nigeria

Background: Complications during pregnancy and childbirth are leading causes of death and disability among women of reproductive age in developing countries even though majority of these deaths are due to preventable causes; consequently, improving maternal health is one of the Millennium Development Goals with a target of 75% reduction in maternal deaths by 2015. Objective: To determine the prevalence of obstetric complications in both orthodox and un-orthodox health care in Osisioma-Ngwa LGA., Abia state, Nigeria. Methods and Materials: A descriptive cross-sectional study carried out in Osisioma-Ngwa LGA,Abia State, among 431 women of child bearing age selected using systemic sampling method. Data were collected using a self- administered questionnaire; data analysis was done using Statistical Package for Social Sciences (SPSS) version 26. Result: Out of the 431 participants in the study, there was 384 (90%) response rate, 178 (46.40%) had Ante-natal Care (ANC) in non-orthodox centers, whereas 206 (53.60%) had ANC in orthodox centers. One hundred and twenty-one (31.50%) delivered their babies outside a hospital setting and 263 (68.50%) had their babies in orthodox setting. Out of 92 (24.40%) of those who had problem during pregnancy, 51 (55.43%) of them had ANC outside a hospital setting while 41 (44.57%) used the hospital ANC. These problems were hypertension 22 (23.91%) and bleeding 70 (76.09%). Also, out of 231 (60.20%) of those who had problem during delivery or immediately after, 119 (51.52%) delivered outside a hospital setting. Prevalence of complication is 13.28% from non-orthodox centres against 10.68% from orthodox centres. The major problems included; bleeding per vaginum 120 (31.25%), failure to progress in labor 53 (13.80%), fever 51 (13.28%). Conclusion: The findings in this study suggest the importance of strengthening maternal and child health policies in the state. The prevalence of obstetric complications is higher with the patronage of non-orthodox obstetric care facilities.

Rancangan video animasi edukasi kesiapsiagaan bencana non alam COVID-19 bagi ibu hamil. Uji validitas dan reliabilitas instrumen

Background: COVID-19 is transmitted through air transmission. Prevention of transmission of the COVID-19 virus in pregnant women will certainly reduce complications in pregnant women and the fetus. An educational animated video design can help increase pregnant women's understanding of preventing the transmission of COVID-19. The Coronavirus disease 2019 or COVID-19 in pregnant women will increase the risk of severe infection and pregnancy complications such as preterm labour. Pregnancy will cause physiological changes and maternal immunity, so pregnant women are in a high-risk group for COVID-19 infection. Prevention of COVID-19 virus transmission in pregnant women needs to be done to prevent complications in pregnant women and fetuses. Research objectives: The design of educational animated videos can help increase the understanding of pregnant women in preventing COVID-19 transmission and to test the validity and reliability of instruments.Method: Developing an educational video animation for non-natural disaster preparedness is carried out in several stages, namely making scenarios, storyboards, sketches, choosing colors, coloring, layering and combining them into animated videos. Then, the animated video was validated by a team of experts from the Langsa City Health Office. The content of this video is about preventing COVID-19 transmission in pregnant women. The animated video was tested on 20 respondents in June 2021 in Karang Anyar village, Langsa City. Furthermore, the instrument was tested for validity and reliability on 20 respondents in July 2021 in Paya Bujok Tunong Village, Langsa City.Results: Are 10 components assessed from educational animated videos, and the majority are very good ≥65%. The results of the validity and reliability tests show that the questionnaire is suitable for use in the condition of pregnant women when facing COVID-19 (p &gt; 0,05). However, one invalid statement item was found. The reliability test results show that all variables have an alpha value above 0,378.Conclusion: Respondents can use and distribute animated videos and research instruments.

Optimising IVF Outcomes

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women, with an overall prevalence of 5% to 15%, and a frequent cause of infertility. Ovulation disorders are the main cause of infertility for the couples. A range of endocrine and metabolic traits are also associated with PCOS and these include obesity, dyslipidemia, insulin resistance, hyperinsulinism and an increased risk of type 2 diabetes mellitus and cardiovascular disease. Studies have found that women with PCOS had a higher live birth rate, clinical pregnancy rate and implantation rate, as well as an increased risk of ovarian hyperstimulation syndrome (OHSS), pregnancy complications including miscarriage, preterm delivery, gestational diabetes mellitus and pregnancy-induced hypertension in their first IVF treatment when compared with non-PCOS controls. During the past three decades, applying IVF for infertility treatment PCOS women has increased significantly, and the landscape of treatment strategies has changed dramatically. GnRH agonist triggering oocyte maturation combined with freeze-all embryos is an effective and commonly used protocol nowadays to achieve good success rate as well as to minimize the risk of OHSS in women with PCOS. Recently, there has been an increasing use of oocyte in-vitro maturation (IVM) for treating infertility in women with PCOS. IVM technique could be considered as an alternative to IVF in centers where it is available. However, strategies to minimize pregnancy complications in women with PCOS remain further studied.

Association between plasma fluoride levels and pregnancy complications in women living in the rural and urban areas of Settat-Morocco

Association between plasma fluoride levels and pregnancy complications in women living in the rural and urban areas of Settat-Morocco

Correlation Between Postpartum Myometrial Elasticity and Obstetric Complications in Pregnant Women with Gestational Diabetes Mellitus.

To investigate postpartum myometrial elasticity in pregnant women with gestational diabetes mellitus (GDM) using shear wave elastography (SWE) and analyze the correlation between myometrial SWE values and obstetric complications. Clinical data of women who gave birth at Affiliated Hospital of Yangzhou University from August 2022 to July 2023 were retrospectively analyzed and divided into two groups based on GDM diagnosis: the GDM group and the healthy control group. SWE was used to measure the elasticity values of the anterior and posterior myometrial walls in both groups. Differences in placental attachment position and SWE values at the placental attachment site were compared between the two groups. Spearman correlation analysis was utilized to evaluate the correlation between SWE values and obstetric complications. Glycated hemoglobin (HbA1c), homeostasis model assessment of insulin resistance (HOMA-IR), fasting plasma glucose (FPG), 2-hour postprandial glucose (2h PG), triglycerides (TG), and total cholesterol (TC) levels were higher in the GDM group than in the healthy control group (P<0.05). There was a statistically significant difference in placental attachment position between the two groups (P<0.05). In both the GDM (17.52±0.42 vs 25.29±0.74, P=0.001) and control groups (14.06±5.01 vs 22.20±6.34, P=0.001), mean SWE values were significantly lower for anterior versus posterior placental attachment, and mean SWE values were also significantly higher in the GDM versus control group for both anterior (17.52±0.42 vs 14.06±5.01, P=0.001) and posterior placental attachment (25.29±0.74 vs 22.20±6.34, P=0.001). Spearman correlation analysis showed that postpartum hemorrhage (r=0.632, P=0.017), preeclampsia (r=0.818, P=0.014), premature rupture of membranes (r=0.710, P=0.012), placental abruption (r=0.732, P=0.031), and ketoacidosis (r=0.729, P=0.022) were negatively correlated with average myometrial SWE values in the GDM group (P<0.05). SWE values at the placental attachment site were higher in GDM patients than in healthy pregnant women, and myometrial elasticity was positively correlated with obstetric complications.

Визначення особливостей перебігу вагітності та пологів, стану плода і новонародженого у вагітних після застосування допоміжних репродуктивних технологій (дані ретроспективного аналізу)

The rapid growth in the number of infertile couples leads to the development of assisted reproductive technologies (ART). Among the most common forms of infertility are tubo-peritoneal, endocrine, and caused by the male factor, and prevention of pregnancy complications caused by ART treatment cycles becomes one of the main tasks of practicing clinicians. Purpose - to determine the features of the course of pregnancy and childbirth; to assess the condition of the fetus and newborn in pregnant women after the application of ART to improve the perinatal outcomes of pregnancy and childbirth. Materials and methods. A retrospective clinical and statistical analysis of 334 histories of pregnancy and childbirth of women, as well as medical records of newborns from women, was conducted over the past five years, which formed the ART group - 221 history of pregnancy and childbirth, and the group of spontaneous pregnancy - 113 history of pregnancy and childbirth. Results. The structure of the subjects was statistically significant dominated by pregnant women over the age of 35 years and pregnant women in late reproductive age. The main characteristics of women after the ART application were a statistically significant predominance of somatic and gynecological pathology. The structure of pregnancy complications in women after ART application was dominated by threatening late spontaneous miscarriages, isthmic-cervical insufficiency and vaginitis, and in the structure of labor complications - anomalies of labor activity and premature rupture of fetal membranes. Among newborns from women in the ART group, perinatal mortality was 18.0%. Conclusions. The revealed features of somatic and gynecological anamnesis, as well as aspects of the course of pregnancy and childbirth and the condition of newborns in women after ART application are the basis for an in-depth examination of this category of pregnant women in order to improve approaches to predicting, diagnosing and optimizing preventive measures, as well as to improve the perinatal consequences of pregnancy and childbirth. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. No conflict of interests was declared by the authors.

Caesarean Section for Breech Presentation on Scarred Uterus with Giant Fibroid Praevia

Breech presentation at term occurs in 3-4% of the pregnant population. The fibroid is a source of obstetrical complications in pregnant women in 10 to 40% of cases. We describe a case of a Caesarean section for breech presentation on scarred uterus with giant fibroid praevia measuring just 12 cm/10 cm in diameters.

An interpretation for Chinese expert consensus on how to manage pregnant women of advanced maternal age with scarred uterus

Deferral of marriage and child-bearing age as well as high occurrence of uterine surgery history such as cesarean section and myomectomy in women who are about to have babies are challenging obstetrical health care worldwide, since pregnancy at advanced maternal age and pregnancy with scarred uterus are both high-risk pregnancy. In China, one-child policy had been implemented for three decades and contributes to high cesarean section rates. With family planning policy turning to two and three-child, there are rising pregnancy at advanced maternal age with scarred uterus. A clinical management scheme can help obstetricians a lot to assess risks, prevent pregnancy complications and manage pregnancy in an organized manner. However, there are insufficient studies on relevant clinical issues for the specific population, and there is no consensus or practice guidelines until now. We have developed Chinese expert consensus based on our pioneering research findings on the prevention and treatment strategy for major pregnancy complications in women of advanced maternal age. We formulate the consensus comprising general management scheme to standardize clinical care, practical risk scoring systems to early warn major pregnancy complications, and nationwide expert recommendations to be in accordance with evidence-based appraisal method. Consecutive supervision along with stratified management are highly emphasized. We interpret the consensus containing up-to-date literature review, research findings interpretation and most concerned questions discussion. This consensus interpretation helps standardize how to manage pregnant women of advanced maternal age with scarred uterus and improve the maternal-fetal outcomes.