Second Trimester Of Pregnancy Research Articles

Efficacy of transabdominal cerclage by open laparotomy relative to existing risk factors.

To prevent extreme preterm birth, women with cervical insufficiency are eligible for transabdominal cerclage in case of prior failure or technical impossibility for transvaginal cerclage. This study aimed to identify patient characteristics that affect the success rate of transabdominal cerclage to prevent extreme preterm birth in women with cervical insufficiency. Single-center retrospective cohort study in 87 women who underwent transabdominal cerclage by open laparotomy during first and early second trimester of pregnancy over a 20-year period. Participants were divided into subgroups according to indication for the intervention. Linear regression and meta-regression-analyses were performed to assess the effect of mean cervical length (before and after transabdominal cerclage placement) and gestational age of previous preterm birth, on gestational age at delivery. Kaplan-Meier analysis was performed to evaluate treatment effects on gestational age at delivery. Of 87 women, 62 women underwent a history-indicated and 25 an ultrasound-indicated transabdominal cerclage. Fetal survival was 92%: 91% in the history-indicated and 96% in the ultrasound-indicated group. Median gestational age at delivery was 37.3 weeks, with a median pregnancy prolongation of 163.0 days and with 92% of deliveries ≥34 weeks. Between groups, irrespective of singleton and twin pregnancies, outcomes were comparable. Gestational age at delivery was neither affected by cervical length before transabdominal cerclage, distance between transabdominal cerclage and external os, gestational age of previous preterm birth nor additional progesterone treatment. The efficacy of transvaginal cerclage placement via open laparotomy during high-risk pregnancy is favorable and relates to fetal survival of 92%. Regardless of indication, pregnancy outcomes after transabdominal cerclage are similar, and independent of gestational age at previous preterm birth, cervical length before transabdominal cerclage placement, distance between transabdominal cerclage and external os, and additional progesterone administration.

Association between sleep during pregnancy and birth outcomes: a prospective cohort study

ObjectiveA prospective cohort study was conducted to investigate sleep status during the early and second trimester of pregnancy in pregnant women on adverse birth outcome, such as preterm birth, low birth weight and small for gestational age.MethodsMultivariable logistic regression models were used to analyze the association of sleep status during the early and second trimester of pregnancy with adverse birth outcomes and generated the odds ratio and 95% confidence interval.Results5,418 pregnant women were included in the analysis. In the multivariable model, compared with 7.1–8 h/night, sleep ≤ 7 h/night during second trimester increases the risk of preterm birth (OR: 1.43, 95% CI: 1.12,1.85), and the risk of preterm birth was decreased in pregnant women who slept > 9 h/night (OR: 0.79, 95% CI: 0.53,0.93). Sleep quality, and sleep changes in the early and second trimesters, and sleep duration in the early pregnancy were not statistically associated with preterm birth, low birth weight and small for gestational age.ConclusionsShort sleep duration during pregnancy is associated with a higher risk of preterm birth and longer sleep duration at night is associated with a lower risk of preterm birth, but the latter needs further verification. Sleep status during pregnancy was not associated with low birth weight and small for gestational age. In order to reduce risk of adverse birth outcomes, sleep problems in pregnant women should be strengthened during pregnancy care.Clinical trial numberNot applicable.

Use of Peer Support Group to Improve Knowledge on Exclusive Breastfeeding among Women of Reproductive Health in Kenya

Introduction: The World Health Organization (WHO) in collaboration with the United Nations Children’s Fund (UNICEF) advocates and promotes continued feeding of breast milk for children at least six months with no other liquids or solids given. The foremost maternal problems that have been recognized for not continuing feeding the infant on breastmilk for the first six months of their life consist of knowledge on how to manage insufficient breast milk, cracked, sore or painful nipples, engorged breast that causes mother’s pain during breastfeeding, return to work or school by the mother and poor latching. Methods: A quasi-experimental intervention was undertaken in Makueni County, with a sample size of 721 participants. Pregnant mothers recruited at their second trimester of pregnancy the mother-baby pair followed up till 6 months after delivery. The peer support group as an intervention was used to deliver concepts on exclusive breastfeeding in the intervention group, while the control group received the routine health information as indicated in the Ministry of Health guidelines. Results: The results of an independent t-test for knowledge on exclusive breastfeeding in the intervention group indicated the mean score for knowledge improved from 38.2% to 81.64%. Women in the intervention group were more knowledgeable about exclusive breastfeeding than those from the control group post-intervention (81.64% & 47.24%, respectively) (p-value <0.001). Conclusion: Peer support is a key intervention in supporting mothers to improve their knowledge and demystify myths and misconceptions about exclusive breastfeeding, therefore engaging the mother and encouraging her to sustain the skill of exclusive breastfeeding

Amniotic Fluid and Maternal Serum Laeverin Levels and Their Correlations with Fetal Size and Placental Volume in Second Trimester of Pregnancy—A Prospective Cross-Sectional Study

Background: Laeverin is an extravillous trophoblast marker playing a significant role in trophoblast migration. We endeavored to estimate the association between the amniotic and serum laeverin concentrations at 16–22 weeks of gestation and the fetal and placental ultrasound measurements in high-risk uncomplicated pregnancies. Methods: A prospective cross-sectional study of consecutively recruited singleton pregnancies undergoing amniocentesis was performed. Fetal structural malformations and/or aneuploidy were the exclusion criteria. Fetal biometric parameters and placental growth/perfusion were assessed by ultrasound in 44 high-risk pregnancies who had no pregnancy complications and any other chronic disease. Maternal serum and amniotic laeverin levels were essayed with sandwich enzyme-linked immunosorbent assay. Results: Serum laeverin levels are decreasing marginally with the maternal age in mid-gestation. Laeverin levels in the serum correlated minimally negatively with head size of the fetus (β = −0.38; p < 0.05; 95% confidence interval (CI) −0.03–0.01), whereas the amniotic level correlated strongly with the fetal abdominal circumference (β = −0.74; p < 0.05; 95% CI: −0.34–−0.09). In addition, the amniotic laeverin level correlated moderately and positively with the placental volume (β = 0.46; p < 0.05; 95% CI: 0.01–0.08). Conclusions: Laeverin levels detected in the serum and in the amniotic fluid denote the fetoplacental growth in uncomplicated high-risk pregnancies.

Muscle invasive bladder cancer treated with gemcitabine plus cisplatin as neoadjuvant chemotherapy during the second trimester of pregnancy

IntroductionMuscle invasive bladder cancer during pregnancy is scarcely reported.Case presentationA 41‐year‐old ex‐smoker Asian female, managed with clean intermittent catheterization for 3 years due to neurogenic bladder caused by spinal cord disease, presented with gross hematuria at 10 weeks of gestation. The patient was diagnosed with muscle invasive bladder cancer, cT3aN0M0. Maternal treatment was prioritized and gemcitabine plus cisplatin as neoadjuvant chemotherapy was started at 17 weeks of gestation. Cesarean section was performed at 32 weeks of gestation, followed by robot‐assisted radical cystectomy 3 weeks later. Histopathological examination revealed urothelial carcinoma, G3, ypT3b. Postoperative adjuvant nivolumab followed by enfortumab vedotin was not successful and the patient died 8 months after robot‐assisted radical cystectomy. Unfortunately, the premature infant with congenital heart disease died of necrotizing enterocolitis at 1‐month‐old.ConclusionGemcitabine plus cisplatin chemotherapy in the patient with muscle invasive bladder cancer during pregnancy was safe but ultimately resulted in unfavorable outcomes in this case.

Incomplete Uterine Rupture During the Second Trimester of Pregnancy, Successful Management With Continued Gestation Until 37 Weeks: A Case Report

Incomplete Uterine Rupture During the Second Trimester of Pregnancy, Successful Management With Continued Gestation Until 37 Weeks: A Case Report

Maternal Serum Catestatin Levels in Gestational Diabetes Mellitus: A Potential Biomarker for Risk Assessment and Diagnosis.

Background/Objectives: Gestational diabetes mellitus (GDM) presents significant risks for both maternal and neonatal health, affecting fetal growth and increasing the likelihood of future diabetes mellitus (DM) development in affected women. The dysregulation of metabolic biomarkers, including catestatin, has been implicated in GDM pathophysiology. However, the clinical significance of catestatin in GDM remains poorly understood, particularly in the context of different therapeutic approaches. Methods: This observational, prospective, and cross-sectional study was conducted to evaluate maternal serum catestatin levels in gestational diabetes mellitus (GDM) patients and healthy controls. Data were collected at a single time point during the second trimester of pregnancy (24 to 28 weeks). Participants were categorized based on their glucose tolerance and GDM management strategies (diet regulation or insulin therapy). Results: Receiver Operating Characteristic (ROC) analysis demonstrated the diagnostic significance of serum catestatin levels in GDM, suggesting a cut-off value of >9.61 ng/mL for discriminating between women with and without GDM. However, further research is needed to elucidate the mechanistic role of catestatin in GDM and its utility in guiding therapeutic interventions. Conclusions: Our study highlights the potential of catestatin as a biomarker for GDM risk stratification and monitoring, complementing existing diagnostic tools. Integrating metabolic biomarkers like catestatin into clinical management approaches may optimize maternal and neonatal health outcomes in GDM. However, the limitations of our study, including its cross-sectional design and sample size, underscore the need for future multicenter studies to validate our findings comprehensively.

Risk assessment of hypertensive and metabolic disorders in pregnant women with COVID-19

According to international research data, COVID-19 increases the risk of developing hypertensive and metabolic disorders. Aim of the study was to assess the risks of hypertensive and metabolic disorders in pregnant women with COVID-19 and to identify potential markers of these conditions. Material and methods. The study involved 265 pregnant women, infected in the first, second, and third trimesters of pregnancy, and uninfected with COVID-19, from 2020 to 2022. Spectrophotometric methods were used to evaluate blood level of glucose, total cholesterol, high- and low-density lipoprotein (LDL), and triglycerides. ELISA was used to measure content of oxidized LDL and apolipoprotein B (apo B). Results. Gestational arterial hypertension (GAH) developed more frequently in women with COVID-19 infected in the second trimester compared to those infected in the third trimester (15.7 and 6.1 % cases, respectively, p = 0.044). Gestational diabetes mellitus (GDM) was more commonly diagnosed in pregnant women with COVID-19 than in those uninfected (17.2 and 4.0 % cases, respectively, p = 0.015), particularly in those infected in the second and third trimesters (17.6 and 18.9 %, respectively). Pregnant women with COVID-19 showed an increase in glucose levels by 1.14 times (p = 0.001), oxidized LDL by 1.24 times (p = 0.042), and apo B protein by 1.14 times (p = 0.025) in blood serum. Conclusions. Infection with COVID-19 in the second trimester of pregnancy increases the risk of GAH by 2.56 times, and in the second and third trimesters, the risk of GDM by 4.3 times. Increase of glucose, oxidized LDL, and apo B content in blood serum may have prognostic significance in the development of hypertensive disorders.

The histological development of the fetal human inferior colliculus during the second trimester.

The inferior colliculus (IC) is an important midbrain station of the auditory pathway, as well as an important hub of multisensory integration. The adult mammalian IC can be subdivided into three nuclei, with distinct cyto- and myeloarchitectonical profiles and distinct calcium binding proteins expression patterns. Despite several studies about its structural and functional development, the knowledge about the human fetal IC is rather limited. In this paper we first systematically describe the histological development of the human fetal IC and its subparts in five stages of the second trimester of pregnancy: 15 gestation weeks (GW), 18 GW, 21 GW, 24 GW, and 27 GW. We 3D reconstruct and calculate the volumetric growth of IC from one stage to another, which increases from 12.85 mm3 at 15 GW to 34.27 mm3 at 27 GW in the left hemisphere. The volumetric changes in the IC were further evaluated at the cellular level using serial Nissl-stained sections, as well as glial fibrillary acidic proteins (GFAP) and calretinin immunohistochemistry. We identify stellate-like and round neurons in the central nucleus of the IC (CNIC) at 24 GW and 27 GW, comparable to the adult human IC. Novel in this study, we investigate the differential calretinin expression patterns in the IC subparts, from 15 GW to 27 GW. CR labeling is identified mainly in the cortical IC rather than in the central nucleus. Furthermore, using GFAP, we describe the radial glial fibers patterns in IC, which are dominant at 18 GW and gradually taper off at later developmental stages. Finally, we describe the development of astroglia in each of the five developmental stages. All these results indicate that the human fetal IC development and cellular maturation occur in two major stages during the second trimester.

Early-life sodium restriction programs autonomic dysfunction and salt sensitivity in male C57BL/6J mice.

Preterm birth increases the risk of cardiometabolic disease in adulthood. Infants born during the second trimester of pregnancy, a critical period of hypothalamic development, are at risk of sodium (Na) depletion due to renal immaturity and large urine Na losses. We previously demonstrated in male mice that Na restriction during the equivalent mouse hypothalamic development period [postnatal day (PD)21-PD42] programs long-term changes in energy balance via increased thermogenic sympathetic nervous activity. We therefore hypothesized that early-life Na restriction programs changes in cardiovascular control via altered autonomic activity. C57BL/6J male mice were supplied a low (0.04%) Na or supplemented (0.30%) Na diet from PD21 to PD42, before return to standard (0.15%) Na diet. Hemodynamic and autonomic functions were assessed by radiotelemetry and acute administration of autonomic antagonists before and after all animals were switched to a high Na diet (HSD; 1% Na) at 12 wk of age. Mice were additionally treated with the angiotensin II type 1 receptor antagonist losartan for 2 wk. On standard diet, early-life Na restriction resulted in small but significantly different hemodynamic responses to autonomic blockers without any effect on systolic blood pressure (SBP) or heart rate. HSD increased SBP in 0.04% but not 0.30% Na mice, accompanied by increased cardiac sympathetic activity. Losartan had a greater BP-lowering effect in early-life Na-restricted mice. Our findings suggest that Na restriction during a critical hypothalamic developmental period programs long-term changes in the autonomic control of cardiovascular functions and may offer insight into the increased risk of cardiovascular disease in former preterm infants.NEW & NOTEWORTHY Mechanisms by which preterm birth increases the risk of adult-onset cardiometabolic diseases are not well understood. The renin-angiotensin system (RAS) has been implicated in the programming of adult disease, although contributors to RAS dysregulation remain to be identified. Findings from this study suggest that failure to maintain postnatal sodium homeostasis during a critical developmental window may contribute to RAS dysregulation and the risk of salt sensitivity of autonomic and cardiovascular function.

The impact of Ramadan fasting on oxidative stress levels in the second trimester of pregnancy

Background The primary objective of this study was to assess the effect of fasting during Ramadan on maternal oxidative stress levels and foetal development; pregnant women with uncomplicated, singleton pregnancies in the second trimester. Methods During the month of Ramadan, 23 March 2023 to 20 April 2023, 50 fasting and 50 non-fasting healthy pregnant women were enrolled in this prospective study. The fasting hours were about 14 h per day in that season. Pregnant women in the second trimester were enrolled in the study. Total antioxidant status (TAS), total oxidant status (TOS) and the oxidative stress index (OSI) were measured from maternal serum samples taken on a fasting day at the end of Ramadan. To evaluate the impact of Ramadan on the foetus, Doppler ultrasonography was performed in the beginning and then at the end of Ramadan in all participants and was used for the following measurements: Increase of biparietal diameter, femur length, estimated foetal body weight, amniotic fluid index and umbilical artery systolic/diastolic ratio. To discern differences between distinct cohorts, independent t-tests and Mann–Whitney’s U-tests were employed based on the data distribution. A p value threshold of less than .05 was established to determine statistical significance. Results TAS level was found to be significantly lower in the group that fasted for more than 15 days compared to the non-fasting group that did not fast (p = .003), but no significant differences were found between the groups in terms of TOS and OSI (p < .05). Obstetric ultrasound parameters showed no significant differences between the two groups (p < .05). Conclusions The present study suggests that fasting during the second trimester of pregnancy does not substantially impact maternal or foetal health, as indicated by most oxidative stress markers and foetal parameters studied. However, the observed reduction in the TAS levels in the fasting group warrants further investigation.

Spontaneous haemoperitoneum in the second trimester of pregnancy

We report the case of a 34 year old woman who presented to secondary care at 18 weeks gestation with acute abdominal pain. A diagnosis of haemoperitoneum secondary to a ruptured ovarian cyst was made and conservative management undertaken.

Pathomorphological changes of the placenta in coronavirus disease (COVID-19) in pregnant women in the second and third trimesters of pregnancy

Despite the severity of the course of COVID-19 in pregnant women, COVID-19 remains a risk factor for perinatal losses. The aim of the study was to determine the pathomorphological changes in the placenta in pregnant women with COVID-19 during the second and third trimesters of gestation in cases of live birth and antenatal fetal asphyxia. Placentas of pregnant women with COVID-19 were examined: in cases of live birth (n=122; Group I), in cases of antenatal fetal asphyxia (n=27; Group II), and in a comparison group (n=40). Macroscopic, microscopic, immunohistochemical, morphometric, and statistical methods were used. Subgroups: I.1 (n=49) – COVID-19 in the mother at 19-34 weeks of gestation and I.2 (n=34) – at 35-40 weeks. Placentas in antenatal fetal asphyxia, depending on the duration of the post-COVID interval (the time interval from the diagnosis of COVID-19 to delivery), were divided into subgroups – II.1 (n=8) and II.2 (n=19). In subgroup II.1, the post-COVID interval was 5-17 weeks; in II.2 – 1-4 weeks. In the acute phase of the disease, placentas predominantly showed congestion, thrombosis, hemorrhages, and placentitis – 100% (95% CI: 94.5%-100%). An increase in the number of syncytial nodules was found in subgroup I.2: 12.7 [11; 14] compared to 5.8 [5; 7] in the control group, p&lt;0.0001. A decrease in the number of terminal villi was observed in subgroups I.1 and II.1 – 16.3 [10; 25]; 10.3 [8; 12] respectively; p&lt;0.0001, compared to 25.4 [20; 30] in the comparison group. All cases of COVID-19 in the mother were accompanied by edema of the stromal tissue of the terminal villi of the chorion, which led to a decrease in the percentage of blood vessels in the terminal villi: in subgroup I.2 – 29.4 [25.6; 34.2]; II.1 – 16.5 [10.34; 24.37], and II.2 – 14.71 [10.1; 19.4] compared to 67.6 [58.78; 73.7] in the comparison group; p&lt;0.0001. Proliferative changes in the wall of arterioles with subsequent arteriosclerosis were observed exclusively in subgroups I.1 and II.1 – 28.6% (95% CI: 16.6%-42.3%) and 100% (95% CI: 78.6%-100%) respectively. Pathomorphological changes in the placenta in COVID-19 during pregnancy are associated with the timing of infection and the phases of the inflammatory process, with an increase in the duration of the post-COVID interval – exudation (placentitis, edema of chorionic villi), proliferation followed by fibrosis. Factors that disrupt placental perfusion in the acute phase of COVID-19 include edema of the villous stroma, narrowing of the capillary lumen in the terminal chorionic villi, and the intervillous space. Compensatory mechanisms of the mature placenta include the appearance of a large number of syncytial bridges to increase the intervillous space and focal inflammation. Arteriolosclerosis, obliteration of the intervillous space, and hypoplasia of the terminal villi caused by SARS-CoV-2 damage to stem and semi-stem villi during COVID-19 in the second trimester of pregnancy are mechanisms of chronic placental insufficiency and a risk factor for intrauterine fetal hypoxia.

Mobilisation and replenishment of phosphorus reserves in Bos indicus cows. 1. Mid-pregnant mature cows post-weaning

Context Lactating beef cows grazing phosphorus (P)-deficient pastures often mobilise body P to alleviate a P deficiency. Knowledge of the circumstances when body P is mobilised, and later replenished, is necessary for optimal management of the P nutrition of breeder herds. Aims To investigate mobilisation and replenishment of body P in mature Bos indicus-cross beef cows post-weaning. Methods Cows (n = 40) in their second trimester of pregnancy were individually fed ad libitum low-P (LP) or high-P (HP) diets containing moderate or high metabolisable energy (ModE-LP, HighE-LP, ModE-HP and HighE-HP) for 14 weeks. Key results Plasma inorganic P concentrations (Pi) in LP- or HP-diet cows (0.58 and 2.15 mmol/L respectively) indicated that diet P was deficient or adequate. Intakes of DM and metabolisable energy, liveweight gain, and P retention were higher (P &lt; 0.05 to P &lt; 0.001) in cows fed the HP diets, and were also increased in the high metabolisable-energy diets. Efficiency in use of metabolisable energy for slow growth was lower in the HighE-LP than the ModE-HP cows. The cows fed the LP diets mobilised 4–5 g body P/day. Cows fed the Mod-HP and HighE-HP diets retained 1.1 and 8.8 g body P/day, and those ModE-HP cows with low bone P reserves retained ~2.3 g P/day. Rib cortical bone P did not change in HP cows but decreased (P &lt; 0.05) in LP cows. The HP diets increased the bone volume, mineralised bone, and the thickness of the struts in trabecular bone in the tuber coxae. Osteoid tissue decreased (P &lt; 0.05) in HighE-HP cows. Changes in plasma concentrations of 1,25-dihydroxy vitamin D3, carboxy-terminal telopeptides of type I collagen (CTX-1) and bone alkaline phosphatase (BAP) were in accord with substantial bone mobilisation in cows fed LP diets, and bone replenishment with HP diets. Conclusions Cows that had ingested P-deficient diets during lactation were able to further mobilise body P when fed LP diets post-weaning, but cows replenished body P when fed HP diets. Implications Mature cows with low body P reserves can replenish these reserves more rapidly when consuming diets high in both P and metabolisable energy.

Global prevalence of constipation during pregnancy: a systematic review and meta-analysis

BackgroundConstipation is a common complication and an unpleasant experience during pregnancy. Due to hormonal factors, intestinal movements decrease during this time, causing the digestive system to malfunction. This study aims to explore the worldwide prevalence of constipation during pregnancy to prevent and minimize its complications.MethodResearchers conducted a meta-analysis of published data on the prevalence of constipation in pregnancy. The articles, which covered the period 1966 to 2024, were collected by searching Embase, PubMed, Scopus, Science Direct, Wos, and the Google Scholar search engine. The initial search was conducted on July 21, 2024, and the final update was made on August 10, 2024.ResultsThirteen studies were identified to determine the prevalence of constipation during pregnancy. The results show that the global prevalence of constipation throughout pregnancy is 32.4%, with the first trimester at 21.1%, the second trimester at 34%, and the third trimester at 30.3%.ConclusionAccording to a study, constipation is most common during the second trimester of pregnancy and the least common during the first trimester. Further research on the causes of constipation and prevention methods can help decrease its prevalence during pregnancy. Therefore, it is important to provide educational interventions on nutrition and encourage moderate physical activity during pregnancy to reduce the occurrence of constipation.

The relationship between excessive iodine during pregnancy and adverse pregnancy complications.

Iodine nutrition during pregnancy plays an important role in fetal development and maternal outcomes. Iodine deficiency has been proved to be associated with maternal thyroid dysfunction, adverse fetal outcomes and neurodevelopmental disorders in offspring. At present, there are few studies concentrate on the effects of iodine excess during pregnancy on thyroid function, maternal and neonatal outcomes, and the results are still controversial. The aim of this study was to evaluate the effects of excessive iodine status on thyroid function, glycolipid metabolism, and maternal and neonatal outcomes. A total of 595 pregnant women who gave birth at the First Affiliated Hospital of Nanjing Medical University from January 2023 to December 2023 were included in this study. Blood and urine samples were collected during the second trimester of pregnancy. Thyroid function include thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3) and urinary iodine concentrations (UIC) were measured. Maternal and neonatal outcomes were collected. Participants were divided into four groups based on UIC, with median UIC values of 100.5, 200, 314.2, and 655 μg/L, respectively. UIC was found to be positively associated with TSH, and negatively associated with FT3 and FT4. Fasting blood glucose (FBG) levels were elevated both in iodine deficiency and excess group. A U-shaped relationship between UIC and thyroid dysfunction were found. Iodine deficiency, excess iodine and even more than adequate iodine can lead to increased incidence of thyroid diseases such as isolated hypothyroxinaemia and overt hyperthyroidism. Importantly, iodine excess was found to be related with higher prevalence of umbilical cord around neck and eclampsia as well as higher blood glucose and low-density lipoprotein(LDL) level. Abnormal iodine status especially iodine excess during pregnancy was found to be related with higher prevalence of adverse mother and fetus outcomes, abnormal blood glucose and lipid level.

The Effect of Clinical Exercise Training on Plantar Pressure, the Subtalar Joint, and the Gait Cycle in Pregnant Women: Randomized Clinical Trial.

Background/Objectives: This study aims to examine the effects of clinical exercise training on foot plantar pressure, the subtalar joint, and the gait cycle during pregnancy. Methods: The study was planned as a randomized, controlled, and single-blind study. Participants' demographic information, obstetric evaluation, physical activity level, fall history, and pain evaluation were recorded. Foot plantar pressure, the subtalar joint, and the gait cycle were measured through pedobarography at Gait Laboratory. The control group was recommended walking. Clinical exercise training was given to the study group 2 days a week for eight weeks. Evaluations were made on day 0 and the day corresponding to the end of week 8. Results: The study was completed with 50 people in the study group (age: 29.7 ± 3.8 years) and 51 in the control group (age: 29.1 ± 6.1 years). As a result of the parametric and non-parametric tests performed before and after the exercise, it was observed that there was a statistically significant difference between the two groups in weight, BMI, pain score, static plantar pressure, dynamic plantar pressure, subtalar joint flexibility, duration of the walking period, and multistep walking speed (p < 0.01). The two groups had a significant difference only in the dominant midfoot plantar pressure (p > 0.05). Conclusions: According to our research, weight control and pain relief are observed in women who engage in clinical exercise in the second trimester of pregnancy; plantar pressure and subtalar joint flexibility are preserved, the walking period does not increase, and the multistep walking speed can be maintained after eight weeks.

Personal growth during early and advanced pregnancy according to women’s mode of conception

ABSTRACT Background Pregnancy can be a complex and stressful period, especially for women conceiving through fertility treatment, but this can foster the experience of personal growth (PG). Most of the knowledge on women’s PG during pregnancy is based on a single measurement and relates to conceiving achieved through fertility treatments in general. Relying on Schaefer and Moos’s PG model, the current prospective study sought to (1) investigate the differences in PG according to women’s mode of conception (spontaneous; first-line fertility treatment; IVF) and (2) examine the contribution of the mode of conception, perceived stress, self-mastery, and cognitive appraisal (threat, challenge, and self-efficacy) to PG in two phases during pregnancy. Methods Israeli pregnant women (Mean age = 32) recruited through a convenience sample, completed self-report questionnaires twice: the first or second trimester of pregnancy (Phase 1; n = 400) and the third trimester (Phase 2; n = 268). A total of 268 participants completed both assessments. Results Women who conceived through IVF experienced higher PG and lower self-mastery than women who conceived spontaneously. Regression analyses indicated that IVF, being primiparous, lower self-mastery, lower threat appraisal, and higher challenge appraisal were related to greater PG in Phase 1. Only expecting the first child and challenge appraisal predicted women’s PG in Phase 2. Conclusions The study highlights that women who conceive through IVF experience greater PG than other women and the significant role of cognitive appraisal in PG over time during pregnancy. These findings may inform focused-based interventions to enhance women’s mental health during this period.

False-positive dengue non-structural protein 1 in pregnancy.

Dengue is a vector-borne infection, which contributes to significant morbidity and mortality in endemic areas. It manifests rapidly within 2 wk from febrile, critical to recovery phase. The point-of-care test (POCT) comprises the non-structural protein 1 (NS1) antigen, IgM and IgG, which aids rapid diagnosis, leading to timely treatment. Despite the high specificity of various POCTs, a few false-positive NS1 cases have been reported. We report the first case of false-positive NS1 antigen in pregnancy. A 24-y-old female in her second trimester of pregnancy presented with fever and chills for 9 d and a non-productive cough for 3 d. The dengue POCT showed NS1 antigen positive, IgM and IgG negative. Her symptoms were resolved with treatment of urinary tract infection with cefuroxime. Urine culture subsequently yielded Escherichia coli. Her recovery and delivery were uneventful. Her NS1 antigen was persistently positive for 18 d. The confirmatory real time-PCR for dengue and pan-Flaviviruses was negative.

Case Report of a Second Trimester Diagnosis of Binder Syndrome

ABinder’s facies is a rare congenital malformation that has multifactorial aetiologies. This anomaly affects the anterior part of the maxilla and the nasal cavity. A 30-year-old primigravida with a non-consanguineous marriage presented for a second opinion regarding an anomaly scan at the fetal medicine department of our institute at 21 weeks. Her scan performed elsewhere suggested a flat and short nasal bridge. A thorough 2D and 3D examination of the fetus was carried out. The midsagittal view of the face showed a flat nose with an increased fronto-nasal angle. In this study, we discuss the diagnosis of Binder syndrome during the second trimester of pregnancy.