Prenatal Research Articles

Extension de l’Utilisation de Gamètes en IntraConjugal (EUGIC) : quel usage des spermatozoïdes d’une femme trans ?

ObjectiveThe French Law relating to Bioethics allows access to medically assisted reproduction for lesbian couples and single women and has expanded the possibilities for self-preservation of gametes. The question now arises of new uses of gametes of the couple, within couples of two cis women, one cis woman and one transgender woman, or two transgender individuals. The acronym EUGIC (Extension of the Use of Gametes in IntraCouple) allows these new situations to be grouped together, particularly if gametes have already been previously cryopreserved, thus avoiding the need for gamete donation. MethodsAnalysis of the different situations of sperm use from a trans woman using gametes available within the couple rather than gamete donation. ResultsThe inconsistency in the use of sperm from a trans woman, the situations already encountered by professionals, the prospects for filiation for a trans woman as well as the issues related to the interest of the unborn child are discussed. ConclusionFrench law does not fully address the use of a trans woman's spermatozoa to meet the new EUGIC requirements and leads to complex situations for healthcare professionals.

Health Literacy Levels of Women Attending a Perinatology Outpatient Clinic for High-Risk Pregnancy Follow-Up.

Health literacy, defined as the ability to obtain, understand, evaluate, and apply health information with knowledge, motivation, and skills, is crucial for maintaining and improving quality of life. Despite the availability of health information, limited health literacy is linked to health disparities, inadequate self-management of chronic diseases, and poorer health outcomes. The purpose of this study is to assess the health literacy of pregnant women who visit the Perinatology Outpatient Clinic for follow-up care. It seeks to identify gaps in knowledge and understanding that may impede effective healthcare delivery and inform targeted health education and public awareness programs to enhance health literacy. This prospective survey study included 210 pregnant women aged 18 to 40 years attending the Perinatology Outpatient Clinic at Giresun Obstetrics and Gynecology Training and Research Hospital, Turkey. Participants completed a questionnaire on health literacy, sociodemographics, and basic health status via Google Forms (Google Inc., Mountain View, CA, USA). Statistical analysis was performed using SPSS Statistics version 26.0 (IBM Corp., Armonk, NY, USA), employing tests such as Kolmogorov-Smirnov, Mann-Whitney U, Kruskal-Wallis, Student's t-test, ANOVA, Spearman, and Pearson correlation, and multivariate linear regression analysis. The mean age of participants was 29.97±5.44 years, with a mean health literacy score of 29.89±7.05. Education level and living place significantly influenced health literacy scores, with higher scores among those with higher education and urban living (p = 0.014 and p = 0.038, respectively). Economic status also significantly impacted health literacy, with lower scores among those with poor economic status (p<0.001). Health literacy scores were higher among those receiving health information from healthcare professionals (p = 0.006) and lower among those finding medical information from doctors insufficient (p = 0.008). Health literacy is significantly influenced by education level, living place, and economic status. The study emphasizes the necessity of focused health education initiatives, especially for individuals with lower educational attainment and those residing in rural regions. Improving health literacy via efficient communication from medical professionals can benefit expectant mothers and their unborn children by lowering medical expenses and improving health outcomes.

Spatial Transcriptomics Analysis: Maternal Obesity Impairs Myogenic Cell Migration and Differentiation during Embryonic Limb Development.

Limb muscle is responsible for physical activities and myogenic cell migration during embryogenesis is indispensable for limb muscle formation. Maternal obesity (MO) impairs prenatal skeletal muscle development, but the effects of MO on myogenic cell migration remain to be examined. C57BL/6 mice embryos were collected at E13.5. The GeoMx DSP platform was used to customize five regions along myogenic cell migration routes (myotome, dorsal/ventral limb, limb stroma, limb tip), and data were analyzed by GeomxTools 3.6.0. A total of 2224 genes were down-regulated in the MO group. The GO enrichment analysis showed that MO inhibited migration-related biological processes. The signaling pathways guiding myogenic migration such as hepatocyte growth factor signaling, fibroblast growth factor signaling, Wnt signaling and GTPase signaling were down-regulated in the MO E13.5 limb tip. Correspondingly, the expression levels of genes involved in myogenic cell migration, such as Pax3, Gab1, Pxn, Tln2 and Arpc, were decreased in the MO group, especially in the dorsal and ventral sides of the limb. Additionally, myogenic differentiation-related genes were down-regulated in the MO limb. MO impedes myogenic cell migration and differentiation in the embryonic limb, providing an explanation for the impairment of fetal muscle development and offspring muscle function due to MO.

Effect of High Glucose on Embryological Development of Zebrafish, Brachyodanio, Rerio through Wnt Pathway.

Gestational diabetes mellitus (GDM) is a worldwide pregnancy complication. Gestational diabetes can significantly impact fetus development. However, the effects of high glucose on embryological development post-fertilization are yet to be researched. Danio rerio embryos are a great model for studying embryonic development. In this study, the effects on embryological (morphological and genetic) development were examined in the presence of a high-glucose environment that mimics the developing fetus in pregnant women with GDM. Fertilized zebrafish embryos were treated with normal media and high glucose for 5 days from 3 h post-fertilization (hpf) to 96 hpf, respectively, as control and experimental groups. Morphological changes are recorded with microscope images. Hatch rate and heart rate are compared between groups at set time points. RNA-Seq is performed to examine the gene changes in the experimental group. Glucose delayed the zebrafish embryo development by slowing the hatch rate by about 24 h. The brain, heart, and tail started showing smaller morphology in the glucose group compared to the control group at 24 hpf. Heart rate was faster in the glucose group compared to the control group on days 2 and 3 with a statistically significant difference. Among the zebrafish whole genome, the significantly changed genes were 556 upregulated genes and 1118 downregulated genes, respectively, in the high-glucose group. The metabolic and Wnt pathways are altered under high-glucose conditions. These conditions contribute to significant physiological differences that may provide insight into the functionality of post-embryological development.

A formative study of the sociocultural influences on dietary behaviours during pregnancy in rural Bangladesh.

Balanced energy protein supplementation (BEP) is recommended for contexts of high maternal undernutrition by the World Health Organization. Despite recent improvements in undernutrition, Bangladesh remains a context where BEP could help accelerate progress towards nutrition goals. In preparation for an effective trial testing a fortified BEP, a qualitative study was undertaken to better understand sociocultural factors influencing dietary behaviours in pregnancy. Married women of reproductive age (n = 23), their husbands (n = 6) and mothers-in-law (n = 6) were interviewed, and focus group discussions were conducted with women (n = 4). Women had a clear understanding of which nutritious foods are important to consume during pregnancy, including green leafy vegetables, dairy and other animal-source foods. Many explained affordability as a barrier to consuming those foods with the desired frequency. Women acquired information about diet and nutrition in pregnancy from community health workers as well as other women in the community. Most preferred to seek information from their own networks before formal health care providers. Women and husbands generally had positive views about micronutrient supplements, although some mothers-in-law were more hesitant. Some food taboos relating to the consumption of certain foods like duck and pigeon meat persist, mainly stemming from concerns for the unborn child. Opportunities exist to build on existing perceptions of healthy diets, potentially framing food or nutrient supplements as a beneficial 'add-on' to promote a healthy pregnancy. There is a scope to strengthen nutrition counselling, especially for the family members, to dispel myths and misconceptions and promote dietary and other support for pregnant women.

“The Logic of Monsters:” Pere Alberch and the Evolutionary Significance of Experimental Teratology

This paper offers an historical introduction to Pere Alberch's evolutionary thought and his contributions to Evo-Devo, based on his unique approach to experimental teratology. We will take as our point of reference the teratogenic experiments developed by Alberch and Emily A. Gale during the 1980s, aimed at producing monstrous variants of frogs and salamanders. We will analyze his interpretation of the results of these experiments within the framework of the emergence of evolutionary developmental biology (or “Evo-Devo”). The aim is understand how Alberch interpreted teratological anomalies as highly revealing objects of study for understanding the development of organic form, not only in an ontogenetic sense—throughout embryonic development—but also phylogenetically—throughout the evolution of species. Alberch's interpretation of monsters reflects the influence of a long tradition of non-Darwinian evolutionary thought, which began in the nineteenth century and was continued in the twentieth century by people such as Richard Goldschmidt, Conrad H. Waddington, and Stephen Jay Gould. They all proposed various non-gradualist models of evolution, in which embryonic development played a central role. Following this tradition, Alberch argued that, in order to attain a correct understanding of the role of embryological development in evolution, it was necessary to renounce the gradualist paradigm associated with the Darwinian interpretation of evolution, which understood nature as a continuum. According to Alberch, the study of monstrous abnormalities was of great value in understanding how certain epigenetic restrictions in development could give rise to discontinuities and directionality in morphological transformations throughout evolution.

The effect of a behavioural intervention package on quality of life of pregnant women experiencing domestic violence: a randomised controlled trial

BackgroundDomestic violence during pregnancy is especially concerning due to its significant detrimental impact on a woman’s health and that of her unborn child. The study aims to evaluate the effects of a behavioural intervention package (BIP) delivered during pregnancy on the quality of life (QOL), domestic violence (DV), and reproductive and child health (RCH) of women experiencing DV.MethodsA randomised controlled trial was conducted on 211 pregnant women recruited between 18 and 20 weeks of pregnancy and randomly assigned to one of two groups: intervention (n = 105) or control (n = 106). The intervention group received BIP and standard care, while the control group received only standard care for 28 weeks. Study tools included socio-demographic variables, a short-form health survey, an abuse assessment screening tool, and an RCH checklist. The tools were completed once before the intervention and again at 6 weeks postnatal. The tools and their subscales were compared pre- and post-intervention using a paired t-test, or Wilcoxon signed test as appropriate to estimate the effect size at baseline and post-intervention.ResultsPost-intervention, the QOL scores were found to be significant, with a positive effect favouring the intervention as compared to the control group. The BIP intervention, which was found to be significantly effective (P ≤ 0.001) in reducing DV for pregnant women experiencing DV, was higher in the intervention group than in the control group.ConclusionThe BIP may be an appropriate method for treating pregnant women experiencing DV from low socioeconomic strata who attend public hospitals in India to improve their QOL. The approach may offer an intervention that healthcare institutions or other organizations in contact with women at risk of violence can implement.Trial registrationIndian Registry of Clinical Trials CTRI/2019/01/017009. Registered on 09/01/2019.

Pengaruh Aromaterapi Ylang-Ylang terhadap Insomnia Ibu Hamil Trimester III di UPTD. Puskesmas Kuta II

Intoduction: Pregnancy is a sensitive phase in women's lives. Pregnant women have insomnia due to hormonal changes caused by adapting to the fetus's growth and development in the womb. To reduce the incidence of insomnia in pregnant women, non-pharmacological therapy is used, specifically ylang-ylang aromatherapy. The purpose of this study is to assess the impact of ylang-ylang aromatherapy on insomnia in third-trimester pregnant women. Metohds: This study used a quasi-experimental research methodology with a Non-Equivalent Control Group design and accidental sampling, with 34 pregnant women separated into two groups: the experimental group and the control group. The level of insomnia was measured using the PSQI questionnaire, then data analysis was carried out using Mann Whitney. Result: The results showed that there was a difference in the level of insomnia of TM III pregnant women in the experimental group after being given the intervention where the p-value was 0.00 &lt; 0.05. Meanwhile, in the control group, the post-test p-value was 1,000 &gt; 0.05, which means that there was no difference in the level of insomnia in the control group. Analysis using Mann Whitney found that there was a significant effect of giving ylang-ylang aromatherapy on insomnia in TM III pregnant women where the p-value was 0.00 &lt; 0.05. Suggestion: From It is hoped that ylang-ylang aromatherapy will be employed as part of comprehensive midwifery care for TM III pregnant women to lower the occurrence of insomnia.

A new insight for investigating the prenatal and postnatal ossification centers of pelvic and femur bones in white New Zealand rabbits (Oryctolagus cuniculus) using 3D CT, double stain technique, and morphometry

BackgroundThe ossification centers in rabbit limbs are related to fetal age and bone maturation. Objective: To address the limited studies on ossification in the hind limbs of New Zealand rabbits, we investigated the prenatal and postnatal development of the pelvic and femur bones. MethodsDouble staining with Alcian Blue and Alizarin Red, computed tomography (CT), and 3D reconstruction were employed to visualize and analyze ossification centers in detail. ResultsUsing double staining, we observed these patterns: At prenatal days 18 and 21, ossification centers appeared in the ilium. By prenatal days 23 and 25, ossification began in the ischium. On postnatal day 1, ilium ossification centers spread across most of the ilium wings, except for the iliac crest, and new centers appeared in the pubis and cotyloid bones. Most bones had ossified by the third week and one month postnatal, except for the iliac crest and ischial tuberosity. At 1.5 months, both were fully ossified. On day 18 post coitum, an ossification center was visible in the middle of the femur shaft. By day 28 post coitum, ossification extended through the shaft, and postnatally, new ossification spots appeared at the extremities by day one and week one. By the third week, complete ossification of the femur head, lesser trochanter, third trochanter, medial condyle, and lateral condyle was observed. At 1.5 months, the entire proximal extremity was ossified. Conclusion3D CT provided clear imaging of ossification progression in the pelvic and femur bones. This study enhances our understanding of vertebrate skeletal development.

Real-time pre-eclampsia prediction model based on IoT and machine learning

Pre-eclampsia (PET) is a hypertensive disease that occurs during pregnancy or in the postpartum period. It complicates 2% to 8% of all pregnancies and is one of the causes of more than 50,000 maternal deaths and over 500,000 fetal deaths worldwide annually. Adverse birth outcomes due to pregnancy complications have been associated with three delays: delay in recognizing the complication, delay in reaching an appropriate facility, and delay in receiving adequate care when the facility is reached. Thus prevention, timely detection, and care of pregnancy complications can prevent maternal deaths and morbidity. The Internet of Things (IoT) and machine learning (ML) technologies have become the new revolution of research in the field of healthcare. These technologies can be utilized to interconnect various sensors, monitor the health status of a patient, and predict the occurrence of an ailment. This study has designed and prototyped a pre-eclampsia monitoring model based on IoT and machine learning for remotely monitoring the health status of an expectant woman and her unborn child, to enhance early diagnosis of pre-eclampsia and improve birth outcomes. The study involved researching the on most appropriate biosensors and then designing and prototyping the pre-eclampsia watch. To build the pre-eclampsia prediction model the best ML algorithm was empirically analysed. A Naïve Bayes pre-eclampsia prediction model was found to perform better in identifying pregnant women who are at risk of pre-eclampsia after evaluation of various pre-eclampsia models built using decision trees, Naïve Bayes, K Nearest Neighbor (KNN), logistic regression, support vector machines (SVM) and Artificial neural networks (ANN). Lastly, the predictive model was integrated with the pre-eclampsia model to assist in early diagnosis of pre-eclampsia. The prototype generates alerts when the expectant woman is at risk of Pre-eclampsia. The pre-eclampsia watch model can securely capture and transmit expectant women's vital to the cloud for processing and provide timely alerts when the woman is at risk. Further research on the performance and efficacy of the model in a real environment will be done by experimenting with it in a purposively selected sample.

Pregnancy and psychoemotional state of women after in vitro fertilization

Aim. To study the psycho-emotional state of pregnant women after IVF and to identify the factors influencing it.Materials and methods. A total of 104 pregnant women were included in a comparative study. They were divided into two groups: one group consisted of women whose pregnancy occurred after IVF (main group), and the other group consisted of women whose pregnancy occurred naturally (comparison group). Psychodiagnostic questionnaires were used to assess the psycho-emotional state of the pregnant women. Statistical processing was performed using the STATISTICA 10.0 program, and differences were considered significant at a significance level of p=0.05.Results and discussion. The results of the analysis showed that the mean age of pregnant women after IVF was 30.8±1.3 years, which was significantly higher than that of women with natural pregnancy (mean age 22.38±4.6 years). In the group of women who became pregnant after IVF, there were more women with a complicated obstetric and gynaecological history and with extragenital pathology. The results of psychodiagnostic studies showed that women in the IVF group had a high level of anxiety. Factors such as the age of the pregnant woman, history of infertility, longterm and unsuccessful infertility treatment, and the presence of somatic pathology negatively affect the mental health of pregnant women.Conclusion. Thus, a high level of anxiety, fear about the course of the pregnancy and the health of the unborn child is characteristic of women whose pregnancy occurred after IVF. Psycho-emotional reactions are associated with the nature of the pathology of the pregnancy, the duration of infertility treatment and a burdened obstetric and gynaecological history. It is important to create special consultation rooms for psychological support. The help of a perinatal psychologist is necessary. Collaboration between the psychologist and the attending physician can achieve the best results.

Clinical Manifestations and Health Impact of Malaria in Pregnant Women

Malaria during pregnancy poses significant health risks, both to mothers and their unborn children, due to the unique physiological and immunological changes occurring during this period. This review provides a comprehensive examination of the clinical manifestations and health impacts of malaria in pregnant women, highlighting the severity of the disease across different trimesters and its implications for maternal and fetal health. Malaria during pregnancy can cause symptoms like fever, anemia, headaches, fatigue, and nausea, with complications varying by trimester. In the first trimester, malaria can lead to early pregnancy loss and congenital anomalies, while in the second trimester, it can exacerbate maternal anemia and affect fetal growth. The third trimester is associated with an increased risk of preterm labor and adverse fetal outcomes. Placental malaria, characterized by parasite accumulation in the placenta, impairs nutrient and oxygen transfer to the fetus, leading to intrauterine growth restriction, low birth weight, and increased stillbirth risk. Maternal complications include severe anemia, acute respiratory distress syndrome, and potential long-term health effects. HIV infection further complicates malaria during pregnancy, increasing risks for both mother and fetus. Age-related variations and socioeconomic factors also impact malaria severity and management. Effective management strategies include intermittent preventive treatment, insecticide-treated nets, and indoor residual spraying. Addressing malaria during pregnancy requires a multifaceted approach, including enhancing diagnostic tools, improving preventive measures, and ensuring equitable healthcare access. Keywords: Clinical Manifestations, Health, Malaria, Pregnant Women

Protocol for an intervention for new parents experiencing moderate psychosocial adversity: pilot feasibility randomised trial

ABSTRACT Background Parents exposed to psychosocial adversities often experience challenges which, combined with the needs of a new-born infant, can be difficult to manage and increase the risk of poor outcomes for both parents and infants. Psychosocial adversity can disrupt the development of parental-foetal attachment to the baby during pregnancy, which can have a negative effect on parental care and quality of interaction during the postnatal period. This intervention is based on the proposition that enhanced parental capacity to mentalise and emotionally connect to unborn children during pregnancy, and better understanding about how to manage distressing infant behaviour (i.e., persistent crying and sleep problems) will: (i) promote the development of secure parent-infant attachment; (ii) improve antenatal bonding and postnatal parenting; and, (ii) reduce parental distress. Method This protocol is for a pilot randomised control trial evaluating a new intervention, which makes use of innovative technologies to support parents experiencing moderate psychosocial adversity (Australian New Zealand Clinical Trials Registry: ACTRN12622000287730). The New Technology for New Parents (NTNP) intervention provides support using antenatal ultrasound scans and ‘virtual home visits’ during the perinatal period. Quantitative outcomes include mentalising capacity, parental-foetal/infant attachment, and parental competence. Conclusion To the best of our knowledge, no study has evaluated the combined effectiveness of two novel technologies (3D/4D ultrasound scans and virtual home visits) to support parents across the antenatal and postnatal periods. This protocol, which includes the rationale for this innovative intervention, addresses a gap in services for parents experiencing moderate psychosocial adversity.

Interactive iPad-Based Education for Parents of Patients with Cleft Lip and Palate.

To assess the effectiveness of an interactive iPad-based educational module (cleft iBook) in enhancing parent/caregiver education related to cleft lip and/or cleft palate (CL/P) care. A prospective study involving pre- and post-intervention surveys. The study was conducted at a craniofacial clinic in a dedicated children's hospital specifically during initial consultations for CL/P care. Thirty-two participants (parents/legal guardians/caregivers) ≥18 years of age, English and/or Spanish-speaking, and attending with a child with CL/P. Participants were provided with iPads and engaged with the interactive iPad-based educational module. Pre- and post-intervention surveys were administered. The survey assessed the understanding of a CL/P diagnosis and management and usability of the iBook. Survey responses were graded on a 5-point Likert scale. Total scores for pre- and post-intervention surveys were compared. Utilizing the cleft iBook module before consultation significantly enhanced comprehension in multiple domains: prenatal development of CL/P, dento-facial molding, surgical techniques, steps after the initial consultation, postoperative care, and the necessity of long-term care for affected children (P < .01). Cumulative survey scores increased by 10.2 points, reflecting significantly improved responses regarding overall comprehension (P < .001). The interactive, iPad-based cleft educational module emerges as a viable, digital strategy for providing education and empowerment to parents and caregivers navigating the challenges of caring for a child with CL/P. The cleft iBook serves as a readily accessible resource, fostering connections among the child, caregivers, and care team.

Navigating the Labyrinth of Pregnancy-Related Coverage for Undocumented Immigrants: An Assessment of Current State and Federal Policies.

Insurance coverage for prenatal care, labor and delivery care, and postpartum care for undocumented immigrants consists of a patchwork of state and federal policies, which varies widely by state. According to federal law, states must provide coverage for labor and delivery through Emergency Medicaid. Various states have additional prenatal and postpartum coverage for undocumented immigrants through policy mechanisms such as the Children's Health Insurance Program's "unborn child" option, expansion of Medicaid, and independent state-level mechanisms. Using a search of state Medicaid and federal government websites, we found that 27 states and the District of Columbia provide additional coverage for prenatal care, postpartum care, or both, while 23 states do not. Twelve states include any postpartum coverage; 7 provide coverage for 12 months postpartum. Although information regarding coverage is available publicly online, there exist many barriers to access, such as lack of transparency, lack of availability of information in multiple languages, and incorrect information. More inclusive and easily accessible policies are needed as the first step toward improving maternal health among undocumented immigrants, a population trapped in a complicated web of immigration policy and a maternal health crisis. (Am J Public Health. Published online ahead of print August 15, 2024:e1-e10. https://doi.org/10.2105/AJPH.2024.307750).

An atypical basement membrane forms a midline barrier during left-right asymmetric gut development in the chicken embryo.

Correct intestinal morphogenesis depends on the early embryonic process of gut rotation, an evolutionarily conserved program in which a straight gut tube elongates and forms into its first loops. However, the gut tube requires guidance to loop in a reproducible manner. The dorsal mesentery (DM) connects the gut tube to the body and directs the lengthening gut into stereotypical loops via left-right (LR) asymmetric cellular and extracellular behavior. The LR asymmetry of the DM also governs blood and lymphatic vessel formation for the digestive tract, which is essential for prenatal organ development and postnatal vital functions including nutrient absorption. Although the genetic LR asymmetry of the DM has been extensively studied, a divider between the left and right DM has yet to be identified. Setting up LR asymmetry for the entire body requires a Lefty1+ midline barrier to separate the two sides of the embryo, without it, embryos have lethal or congenital LR patterning defects. Individual organs including the brain, heart, and gut also have LR asymmetry, and while the consequences of left and right signals mixing are severe or even lethal, organ-specific mechanisms for separating these signals are poorly understood. Here, we uncover a midline structure composed of a transient double basement membrane, which separates the left and right halves of the embryonic chick DM during the establishment of intestinal and vascular asymmetries. Unlike other basement membranes of the DM, the midline is resistant to disruption by intercalation of Netrin4 (Ntn4). We propose that this atypical midline forms the boundary between left and right sides and functions as a barrier necessary to establish and protect organ asymmetry.

Perspectives of providing magnesium sulfate to patients with preeclampsia and eclampsia: A qualitative study amongst nurse-midwives in Dar es Salaam, Tanzania.

Preeclampsia and eclampsia are among the leading direct causes of maternal death and morbidity worldwide. Up to 34% of maternal deaths in Tanzania are due to preeclampsia/ eclampsia. Magnesium sulfate is recommended for preventing and treating convulsions in women with Preeclampsia or eclampsia. However, evidence suggests limited knowledge of its dosage and proper toxicity assessment after administration among health care providers. This study explored nurse-midwives' perspectives on providing MgSO4 to patients with preeclampsia or eclampsia in Tanzania. A descriptive exploratory qualitative study using in-depth interviews was conducted to understand nurse-midwives' perspectives on providing magnesium sulfate to patients with PE/E. Nineteen nurse-midwives were interviewed from three hospitals in the Dar es Salaam region. We used a semi-structured interview guide in Kiswahili language to collect data. All interviews were digitally recorded and transcribed verbatim. We analyzed data using inductive content analysis. This study revealed that nurse-midwives provide magnesium sulfate to save the lives of women and their unborn children. Nurse-midwives reasoned that confidence in their skill enhances provision of magnesium sulfate. However, they were concerned about its effect on the progress of labour. Ineffective use of magnesium sulfate emerged from inadequate training, an unsupportive work environment, and underutilization of the existing guidelines. Nurse-midwives have clear drive to provide magnesium sulfate to women with preeclampsia or eclampsia. However, inadequate training, underutilization of guidelines and unsupportive work environment lead to ineffective use of magnesium sulfate. Targeted practical training should be emphasized for nurse-midwives mastery of clinical competencies.

Healthy functioning mammal male reproductive system is determined during prenatal development: long-term consequences of maternal immune activation

Healthy functioning mammal male reproductive system is determined during prenatal development: long-term consequences of maternal immune activation

Fetal alcohol spectrum disorders prevention and clinical guidelines research - workshop report

It is estimated that up to 1 in 20 people in the United States may have a fetal alcohol spectrum disorder (FASD), or the array of physical, cognitive, emotional, and social disorders caused by exposure to alcohol during prenatal development (May et al., JAMA 319:474–82, 2018). While this condition is present in a broad range of individuals and families, it has not previously been examined in the military community, where cultural factors including an increased prevalence of alcohol misuse may pose a unique set of challenges (Health.mil, Alcohol misuse, 2024).The Uniformed Services University of the Health Sciences (USUHS), in conjunction with FASD United, hosted the second annual Workshop on Fetal Alcohol Spectrum Disorders Prevention and Clinical Guidelines Research on 20 September 2023 in Washington, DC. Organized as part of a four-year, federally-funded health services research initiative on FASD in the U.S. Department of Defense (DoD) Military Health System (MHS), the workshop provided a forum for exploring the initiative’s focus and progress; examining current knowledge and practice in the research and clinical spheres; and identifying potential strategies to further improve prevention, screening, diagnosis, interventions, and family support. Building off of the 2022 workshop that covered the state of the science surrounding prenatal alcohol exposure and FASD, the 2023 focused primarily on FASD and efforts aimed at identification and management (Koehlmoos et al., BMC Proc 17 Suppl 12:19, 2023). One hundred and thirty attendees from academia, healthcare, federal agencies, and patient advocacy organizations gathered to share research findings; learn from lived experiences; and discuss initiatives to advance research, screening, and services for at-risk pregnant women as well as families and caregivers supporting individuals with FASD.

Convexity dural arteriovenous fistula with Sylvian-Labbé collateral pattern: A case report.

Convexity dural arteriovenous fistula (dAVF) is associated with high-grade dAVF and is usually presented with aggressive clinical presentation. Precise diagnosis and understanding the pathogenesis are important to achieving successful treatment without complications. We report a case of dAVF with Sylvian-Labbé collateral pattern, concerning embryological development that was thought to be involved in the vascular architecture and pathogenesis of dural AVF. Thus, a 60-year-old man was presented with sudden onset of seizure with no history of trauma. Magnetic Resonance Imaging (MRI) showed cortical hemorrhage in the left precentral gyrus. Digital subtraction angiography (DSA) showed the convexity dural arteriovenous fistula (dAVF) involving a vein that appeared to be the vein of Labbé, the drainer was anastomosed with superior middle cerebral vein (SMCV) and formed the varix. With the successful treatment with trans-arterial embolization (TAE), obliteration of dAVF was achieved with no neurological deficits. This case highlights convexity dAVF with the complex relationship between embryological development and the arcade of venous drainage route, wherein the anomaly might be acquired and caused by elevated venous pressure in a vein that appeared to be the vein of Labbé. Gaining knowledge of the embryological basis may aid in a deeper understanding of acquired pathologies.