Management Of Women Research Articles

Perinatal outcomes in pregnancies achieved after fertility treatments with and without diet-controlled GDM.

To evaluate the rates of adverse perinatal outcomes among women who conceived after fertility treatments with and without diet-controlled GDM. In this retrospective population-based cohort study, all pregnancies of non-diabetic and diet-controlled GDM women who conceived after fertility treatments (in-vitro fertilization - IVF and ovulation induction - OI) and delivered between the years 1996-2016 in a tertiary medical center, were included. Pregnancies of women with pre-gestational diabetes mellitus, and those complicated with gestational diabetes mellitus A2, multiple pregnancies, congenital malformations and those lacking prenatal care, were excluded. Demographical, clinical, and obstetrical characteristics were recorded, and pregnancy complications and adverse perinatal outcomes were compared between the groups. Multivariate logistic regression models were used to control for confounders. Statistical analyses were performed using logistic regression to control for potential confounders. A p-value of < 0.05 was considered statistically significant. During the study period, 6254 deliveries met the inclusion criteria, 10.23% of them (n = 640) had diet-controlled GDM. Pregnancies with diet-controlled GDM were found to be associated with significantly higher rates of hypertensive disorders of pregnancy (15.6% vs. 9.8%, p < 0.001), polyhydramnios (5.9% vs. 2.7%, p < 0.001), and cesarean deliveries (40.8% vs. 31.9%, p < 0.001). Diet-controlled GDM was also found to be an independent protective factor against perinatal mortality (aOR = 0.22, 95% Cl 0.05-0.92, P = 0.04) possibly due to the more intensive monitoring and management typically provided to women undergoing fertility treatments. This close care may mitigate some of the risks associated with ART, leading to improved perinatal outcomes. Among pregnancies achieved after fertility treatments, diet-controlled GDM was associated with reduced perinatal mortality and higher rates of certain pregnancy complications. These findings highlight the importance of close monitoring and careful management of women with diet-controlled GDM, as it may help mitigate risks associated with ART pregnancies. Further research is needed to understand the mechanisms behind these outcomes and to optimize management strategies for this specific population.

Exploring female fitness app users' motivations and perceptions: A qualitative study.

Women make up nearly 60% of fitness App users and play an important role in the operation and development of these Apps. Despite the widespread adoption of fitness Apps in recent years due to their many physical and mental benefits, the use of Apps tends to be short-term, and user engagement is relatively low. Little is known about the factors that motivate female users to consistently use fitness Apps. This study aimed to study attributes of fitness Apps that are most likely to influence female users during their use of Apps. The means-ends chain theory and the soft-laddering interview technique were used to analyze the attributes that influenced females' perceptions of fitness apps, focusing on the features most likely to provide them with benefits and value. The results of the study indicated that instructiveness, interaction, personalization, ease of use, and convenience were the most important attributes valued by female fitness App users; peer support, entertainment, and exercise adherence were the most important consequences; and health, self-fulfillment, enjoyment of life and sense of achievement were the most important values. The findings provide researchers and management of fitness Apps and women's sports with valuable insights from the means-ends chain theory, as well as suggestions for applying App design and promotion.

Active management of labour versus expectant management of primiparous women with a prolonged latent phase: a randomized trial

Active management of labour versus expectant management of primiparous women with a prolonged latent phase: a randomized trial

Immune Thrombocytopenic Purpura and Maternal and Neonatal Outcomes During Pregnancy: A Systematic Review and Meta-Analysis.

Immune thrombocytopenic purpura (ITP) affects 1-3 out of every 10000 pregnancies, posing significant risks to both mothers and newborns. The condition often requires careful management to prevent severe hemorrhagic events. PubMed, Embase, Scopus, and Web of Science searched for relevant literature until June 2024. A meta-analysis was performed to evaluate the effect of ITP on maternal and fetal outcomes. The results showed that antepartum hemorrhage occurred in 0.17 (95% CI = 0.12-0.25) of patients and postpartum hemorrhage occurred in 0.11 (95% CI = 0.07-0.16) of pregnant women with ITP. About 0.63 (95% CI = 0.50-0.74) of pregnant women needed treatment for ITP. The cesarean section (CS) rate was 0.48 (95% CI = 0.34-0.61), and the occurrence of preterm labor was 0.14 (95% CI = 0.07-0.24). A total of 0.32 of neonates had thrombocytopenia (95% CI = 0.18-0.52). The difference between the platelet count of those diagnosed with ITP before pregnancy and those diagnosed after pregnancy was significant (MD=-31.50, 95% CI=51.29-11.72, p<0.01). This meta-analysis highlights the significant impact of ITP on pregnancy, estimating risks of bleeding, CS, gestational diabetes, preterm labor, and neonatal thrombocytopenia. These findings underscore the need for vigilant monitoring and tailored management of pregnant women with ITP.

Individualized cell-free DNA biomarker analysis for the management of women with endometrial cancer

Individualized cell-free DNA biomarker analysis for the management of women with endometrial cancer

Trends in Urinary Tract Infection Management in Women.

Urinary tract infections (UTIs) are a common cause of health care utilization in the United States. The coronavirus disease 2019 (COVID-19) pandemic accelerated virtual care for UTIs. This retrospective cohort study analyzes more than 1.2 million encounters for UTI based on diagnosis codes, examining temporal trends focusing on virtual compared with in-person encounters, antibiotic dispensation rates, and culture-confirmed UTIs. From 2015 to 2022, UTI encounters increased by 325.9%, with a majority occurring at virtual visits. The rate of UTI encounters per 1,000 adult female patients increased by 241.6%. Antibiotic dispensation rates increased, surpassing the rise in rate of positive urine cultures, suggesting increasing use of empiric antibiotics. Our findings underscore the importance of balancing telemedicine's accessibility with maintaining antibiotic stewardship and highlight the need for updated guidelines.

Motivations for and experience with labor induction at 39 weeks in women with obesity-A qualitative study.

Timing of induction of labor (IOL) at term has been investigated in multiple settings. In Denmark, the 'When to INDuce for OverWeight' (WINDOW) study compares IOL at 39 weeks of gestation versus expectant management in low-risk women with obesity. However, knowledge on women's expectations of and experience with IOL is sparse. The aim of this study was to explore women's motivation to join the WINDOW study and their experience when randomized to IOL at 39 gestational weeks. A qualitative interview study of 25 pregnant women with obesity randomized in the WINDOW study to IOL at 39 weeks of gestation was conducted. Participants were recruited from four hospitals in Central Denmark Region and were interviewed four to six weeks after giving birth. A thematic analysis was performed using a phenomenological approach. The analysis resulted in three main themes, (1) Motivation for IOL, (2) The IOL process, and (3) IOL in recollection and in the future. Participants perceived inclusion into the WINDOW study as a "great opportunity," as they hoped to be randomized to IOL at 39 weeks of gestation. Their main motivation for participating was physical discomfort in late pregnancy and a wish for "knowing" the timing of the birth. BMI-related risk factors were mentioned by few as a motivating factor. Some participants described the IOL process as a team effort between the couple and the midwives and were positive towards future IOL. Others associated the IOL process with prolonged labor or described the body as "reluctant" to respond to the induction regime. A desire to experience spontaneous onset of labor in a future pregnancy was mentioned. Physical discomfort and wanting to "control" the onset of labor were main motivations for women's decision to participate in the WINDOW study, hoping they would be allocated for IOL. Comprehensive information and being supported by midwives through the IOL process was crucial for a positive IOL experience. Some participants were positive towards a future IOL. Others speculated if their body was not ready for birth in 39 weeks of gestation and/or associated the IOL process with a challenging labor.

DIFFICULTIES AND CONSIDERATIONS IN ANESTHESIA FOR PREGNANT WOMEN: A LITERATURE REVIEW

Introduction: The management of anesthesia in pregnant women presents unique challenges due to the physiological changes that occur during pregnancy. A comprehensive understanding of these changes is essential for ensuring maternal and fetal safety. Objective: This study aims to explore the complexities of anesthetic management in pregnant women, focusing on the necessary adaptations in techniques, potential complications, and the impact of racial and socioeconomic disparities in access to care. Methods: A multidisciplinary approach was employed, including a review of current literature on anesthetic practices, complications, and healthcare disparities. Collaborative strategies among healthcare providers were also examined. A total of 10 articles were selected for meeting the research criteria. Results: The findings indicate that approximately 70% of studies emphasize the importance of tailored anesthetic techniques to address physiological changes. Additionally, disparities in access to anesthetic care were identified, highlighting the need for equitable health policies. Conclusion: Continued research and innovation are vital for improving anesthetic practices and ensuring that all pregnant women receive safe and effective care. This work contributes to the overarching goals of prioritizing maternal and neonatal safety and addresses systemic challenges in anesthetic management.

The role of perspective-taking in attenuating self-group distancing in women managers.

Contrary to expectations about solidarity and sisterhood between women, women managers sometimes distance themselves from junior women in the workplace when facing identity threat, that is, the feeling that one's social identity-such as race or gender-is devalued or undermined. For example, women managers might distance themselves from lower status junior women by seeing themselves as more masculine and career committed than their junior women colleagues. To advance our understanding of how to combat self-group distancing, the present research proposed and tested whether taking the perspective of junior women would attenuate these ingroup-distancing tendencies in women managers. Findings from a field study and an experimental study indicated that women managers reported greater self-distancing from junior women (on masculine trait perceptions) compared to women employees. As predicted, this effect was attenuated for women managers with high levels of perspective-taking (Study 1) and for women who were experimentally led to take the perspective of junior women (Study 2). For ratings of career commitment and support for affirmative actions, we did not replicate the self-ingroup distancing effect reported in the literature. Theoretical and practical implications of these findings are discussed.

Pregnancy and inherited cardiomyopathies: insights from specialized care

Abstract Background Pregnancy and postpartum represent periods of increased risk of cardiovascular complications. Management of women with modified World Health Organization (mWHO) class II–III, III, and IV during pregnancy and around delivery should be conducted at an expert centre by a multidisciplinary team. Purpose Our objective was to analyze the impact of pregnancy on cardiomyopathy outcomes in a centre specialized in inherited cardiovascular conditions in the United Kingdom. Methods All women with cardiomyopathy referred due to pregnancy to our centre between 2016 and 2023 were retrospectively analyzed. Demographic, clinical, obstetric, genetic, electrocardiographic, and multimodal imaging variables were collected. Results Between 2016 and 2023, follow-up and delivery planning were initiated for 86 pregnancies in women with cardiomyopathies referred to our centre, resulting in 81 live births and 5 miscarriages, all in the first trimester. Among the full-term pregnancies, 17 (21%) were in patients in mWHO class I or II, 22 (27.2%) in II-III, 34 (42%) in III, and 8 (9.8%) in IV. The distribution of cardiomyopathy types among different mWHO classification is represented in Table 1. Women in mWHO class ≥ II-III had more pregnancy-related events than patients in mWHO I or II [28 (34.6%) vs 1 (1.2%); p = 0.004]. The most common complication in the first group was supraventricular tachycardia in 11 pregnancies (13.6%), followed by gestational diabetes in 9 (11.1%), left ventricular ejection fraction impairment in 4 (4.9%), preeclampsia in 3 (3.7%), and 1 (1.2%) ventricular tachycardia. One patient in the second group developed gestational diabetes. The distribution of the type of delivery among different mWHO classification is represented in Table 2. Only one patient with hypertrophic cardiomyopathy in mWHO II-III who underwent a caesarean section presented a post-delivery complication related to retroperitoneal haematoma, with no statistical significative differences between the groups (p = 0.604). 100% of the patients survived pregnancy and postpartum period. Conclusions Pregnant women with cardiomyopathy face an increased risk of adverse events. Despite the presence of cardiovascular and obstetric complications, careful monitoring at a specialized centre leads to favourable outcomes particularly concerning mortality rates for both the mother and fetus. This highlights the importance of a comprehensive risk assessment and meticulous pregnancy and delivery planning to ensure optimal maternal and fetal health.Table 1.Cardiomyopathy and mWHOTable 2.Type of delivery and mWHO

Understanding the pathogenesis of infertility in endometriosis - literature review

Introduction and objective Endometriosis is a complex systemic condition characterized by the growth of functional endometrial tissue outside the uterine cavity, affecting 10-15% of women of reproductive age. Up to 50% of these women face infertility challenges. Although there is a scientifically established connection between endometriosis and infertility, the underlying mechanisms remain not fully understood. Review methods The PubMed database was searched using phrases related to the topic of endometriosis-associated infertility. The search included original research articles, review papers, and guidelines, including the Polish guideline on managing women with endometriosis. Ultimately, 25 relevant sources presenting the latest knowledge were selected. Abbreviated description of the state of knowledge The pathogenesis of infertility associated with endometriosis is complex and involves multiple factors. The most frequently cited contributors in the scientific literature include pain and dyspareunia, mechanical factors, reduced ovarian reserve, oxidative stress, changes in embryo and oocyte quality, impaired ovulation, and compromised endometrial receptivity. Summary Endometriosis affects a growing number of women worldwide, with nearly half experiencing infertility. The complexity and involvement of multiple organ systems make it difficult to pinpoint a single cause, posing a challenge for clinicians. Addressing these diverse factors is essential for improving fertility management in women with endometriosis.

A IMPORTÂNCIA DO ACOMPANHAMENTO ODONTOLÓGICO DURANTE O PRÉ NATAL

The study addresses the hormonal and physiological changes during pregnancy that directly affect the oral health of the pregnant woman and can have an impact on the baby. The objective of the work is to highlight the importance of prenatal dental care, addressing the most prevalent oral diseases in pregnant women, the impacts of these conditions on fetal development, the necessary care in the clinical management of pregnant women, and the importance of a multidisciplinary approach in care. The methodology was based on an integrative literature review, using databases such as PubMed, Scielo, and Google Scholar, with descriptors in Portuguese and English. Studies published between 2009 and 2024 that discuss dental interventions in pregnant women and the relevance of prenatal dental care were included. The results indicate that gingivitis and periodontitis are common conditions during pregnancy, potentially leading to complications such as premature birth and low birth weight. Proper dental care, carried out in a multidisciplinary manner, contributes to the prevention of these problems and improves the well-being of both the pregnant woman and the baby.

Green nexus womenpreneurs: harnessing internal-external capabilities for sustainable MSMEs fashion

Purpose This study aims to analyze the capabilities and external conditions of womenpreneur owners of micro, small and medium enterprises (MSMEs) Fashion EcoPrint Indonesia in green business practices and their implications for sustainable business performance. Design/methodology/approach This study chooses a quantitative approach with a sustainable business internal-external capability model. Using the structural equation modeling-partial least square analysis tool, the analysis was conducted on a sample of womenpreneurs who owned MSMEs EcoPrint Indonesia (n = 493). Findings In the internal capability dimension, total quality environment and green core competence affect green supply chain management, affecting green product innovation performance. Meanwhile, women entrepreneurs’ external capability dimensions (regulation, customer awareness of the environment and technological innovation infrastructure) are connected to sustainable development business capabilities, which affect the performance of green process innovation. The study confirms that green products and processes have the potential to influence sustainable business performance. A key finding is the strong influence of environment-based total quality management governance on both sides. At the same time, womenpreneurs have a significant impact on their respective dimensions. Research limitations/implications This study has implications for increasing competency, Sustainable MSME industrial infrastructure, and protecting women in developing countries. The theoretical implications of creating a model that examines the impact of womenpreneurs’ internal and external abilities on eco-friendly businesses’ success are significant for developing nations’ promising growth. Originality/value This study explores women’s contributions to family well-being and environment-based economies, focusing on eco-friendly supply chain management and sustainable external capabilities of women entrepreneurs in Indonesia, using a gender equality approach in developing economies.

Comparison of Differences in Kinetics of Elderly Women at Risk of Falling during Lumbar Stabilization Exercise per Obstacle Height

This study was performed to identify the kinetic and kinematic effects of the lumbar stabilization exercise on obstacle gait(5.2cm,15.2cm) among elderly women at risk of falls. The study subjects were 32 women aged 65 and over with a risk of falls identified by the Tinetti test. They were randomly allocated into 2 groups: the experimental group and the control group, and the lumbar stabilization exercise program was given to the experimental group for 12 weeks. The chi-square test and t-test were used to test homogeneity and compare baseline results of kinetic measurements on obstacle gait between the experimental and control groups. To identify the effects of the lumbar stabilization exercise program among study subjects, repeated measures of analysis of variance (ANOVA) were performed. Regarding kinetic variables, the knee joint angle of the propulsion foot significantly increased when overcoming a 5.2cm obstacle. When overcoming a 15.2cm obstacle, the obstacle overcoming speed and the knee joint angles of the support and propulsion feet significantly increased. However, the shortest vertical distance between the support and propulsion feet was reduced considerably. Our findings suggest that lumbar stabilization exercises could be a promising therapeutic exercise method for fall prevention and management in elderly women at risk of falling, providing reassurance about the effectiveness of our study's findings and the potential benefits for the elderly and other patients requiring trunk stability.

A new approach to the diagnosis and surgical treatment of uterine scar defect after cesarean section

Introduction. An increase in the number of cesarean sections in the world leads to an increase in cases of formation of scar defects on the uterus, which requires attention and the use of new diagnostic and treatment methods. Studying the healing processes of the myometrium is key to preventing the formation of a uterine scar defect, and improvements in diagnostic methods and surgical techniques can reduce the risk of recurrence of a uterine scar defect.Purpose of the study. To develop an effective algorithm for the management of women with a uterine scar defect at the stage of preparation for pregnancy.Materials and methods. A prospective randomized cohort study was conducted using a random number generator method with the participation of 100 women with a uterine scar defect after cesarean section. The participants were divided into two groups: in the first group (35 women), surgical treatment was performed using an anchor thread and a collagen-based hemostatic matrix, while in the second group (65 women), surgical treatment was carried out in the traditional way (laparoscopic metroplasty without the use of additional techniques).Results. A mathematical model has been developed for predicting the risk of recurrence of a uterine scar defect. Using the method of step-by-step discriminant analysis, the most informative predictors of the formation of a recurrent uterine scar defect were identified: shear wave magnitude indicators according to ultrasound elastography, the presence of a cyst in the uterine scar area, the expression of receptors for progesterone and estradiol in the endometrial glands, the expression of CD20 cells and CD138 cells. plasma cells according to an immunohistochemical study of the endometrium.Conclusion. Understanding the main reasons for the formation of a scar defect and the risk factors for its recurrence will make it possible to more accurately predict the outcomes of laparoscopic metroplasty and choose the most appropriate treatment tactics for each specific patient, which, in turn, can improve the overall treatment results and the quality of life of women

Effects of supportive hemodialysis on the management of a pregnant woman with advanced chronic kidney disease: a case report and literature review

BackgroundPregnancy in women with chronic kidney disease (CKD) is associated with an increased risk of adverse maternal and fetal outcomes, including worsening renal function, hypertension, proteinuria, preeclampsia, preterm delivery, stillbirth, and intrauterine growth restriction. Some pregnant women with CKD may require dialysis after conception. Clinical guidelines provide recommendations for optimal hemodialysis prescription in pregnant women undergoing maintenance hemodialysis for end-stage kidney disease. However, the timing of initiation and optimal doses of hemodialysis for pregnant women with non-dialysis advanced CKD remain uncertain.Case presentationWe describe the case of a 29-year-old woman with a history of CKD for at least 2 years. She was referred to our department with a serum creatinine level of 2.48 mg/dL and an estimated glomerular filtration rate of 20 mL/min/1.73 m2. Because she was found to be pregnant at the initial visit, she was referred to the Department of Obstetrics. At 23 weeks’ gestation, she was admitted due to threatened premature delivery and urinary tract infection, which were managed with ritodrine hydrochloride and antibiotics. Owing to maternal weight loss and asymmetrical fetal growth restriction, daily protein intake was increased from 40 g/day to 60–80 g/day. Additionally, supportive hemodialysis (three times per week) was initiated at 26 weeks’ gestation, and the pre-dialysis blood urea nitrogen (BUN) level was consistently maintained < 40 mg/dL. Consequently, the patient’s weight increased, and fetal growth recovered. Because her blood pressure increased particularly during and after dialysis sessions, dialysis was discontinued at 32 weeks’ gestation. Urinary protein increased to a nephrotic level, and blood pressure was poorly controlled by medication, suggesting the onset of preeclampsia. Thus, a cesarean section was performed at 33 weeks’ gestation, and she delivered a male baby weighing 1449 g. Following childbirth, the patient did not require hemodialysis.ConclusionsSupportive hemodialysis during pregnancy in women with advanced CKD can increase maternal protein intake without elevating BUN levels, leading to improved fetal growth.

Development and validation of a multivariable nomogram predictive of hepatitis B e antigen seroconversion after pregnancy in hepatitis B virus-infected mothers.

Current guidelines are controversial regarding the continuation of nucleos(t)ide analogues (NAs) therapy after delivery in Hepatitis B virus (HBV)-infected pregnant women. The postpartum period may be an opportune moment for achieving hepatitis B e antigen (HBeAg) seroconversion earlier with constant NAs therapy due to the restoration of immune function after delivery. We investigated prenatal and pregnant factors associated with HBeAg seroconversion after pregnancy and developed a nomogram to predict HBeAg seroconversion rates, aiding decision-making for optimal management in women. We retrospectively included 489 HBeAg-positive mothers as the training cohort from January 2014 to December 2018 and prospectively enrolled 94 patients as the external validation cohort from January 2019 to December 2021 at the First Affiliated Hospital of Xi'an Jiaotong University. In the training cohort, independent predictors were identified using the least absolute shrinkage and selection operator (LASSO) regression algorithm. Subsequently, multivariate logistic regression was employed to establish the nomogram. Model performance was assessed using the area under the receiver operating characteristic curve (AUC), calibration plots, and decision curve analysis (DCA). Both discrimination and calibration were evaluated through bootstrapping with 1,000 resamples. The external validation cohort was subsequently used to validate the nomogram. Factors such as pregnancy hepatitis flare (OR: 5.122, 95% CI: 2.725-9.928, p < 0.001), NAs therapy after delivery (OR: 15.051, 95% CI: 6.954-37.895, p: <0.001), hepatitis B surface antigen (HBsAg) (OR: 0.549, 95% CI: 0.366-0.812, p: 0.003) and HBV DNA level at delivery (OR: 0.785, 95% CI: 0.619-0.986, p: 0.041) were included in the final risk model. The AUC in the training set was 0.873 (95% CI: 0.839-0.904). The calibration curve of the nomogram closely resembled the ideal diagonal line. DCA showed a significantly better net benefit in the model. External validation also confirmed the reliability of the prediction nomogram. The AUC in the external validation set was 0.889 (95% CI: 0.801-0.953). The calibration curve for the external validation set was in close proximity to the ideal diagonal line. DCA also demonstrated a significant net benefit associated with the predictive model, consistent with the findings in the training set. Finally, the nomogram has been translated into an online risk calculator that is freely available to the public (https://wendyzhong.shinyapps.io/DynNomapp/). We developed a nomogram based on prenatal and pregnant factors to estimate HBeAg seroconversion after delivery in women. This tool provides clinicians with a precise and effective way to identify individuals likely to undergo HBeAg seroconversion postpartum, aiding in decision-making for optimal management.

Tier‐based transformation in women's time management through electricity access: Insights from rural Cambodia

AbstractThis research examines the impact of electricity access on women's time management in rural Cambodia using qualitative methods, including semi‐structured interviews and textual analysis. The study reviews crucial concepts, such as women's empowerment and time poverty and explores how electricity access influences these dynamics. Findings indicate that while previous studies suggest a uniform reduction in time poverty due to decreased drudgery across different levels of electricity access, this study reveals variations. It shows that reductions in time poverty are not only from decreased drudgery but also from increased disposable time, especially in off‐grid conditions where women may experience an increase in drudgery. Moreover, the extent of time poverty reduction varies with the level of electricity access, highlighting a nuanced pattern from off‐grid to national grid scenarios. This study contributes to understanding the gendered impacts of electricity access and its relation to women's autonomy in time management.

Use of continuous glucose monitoring and hybrid closed-loop therapy in pregnancy.

Continuous glucose monitoring (CGM) has led to a paradigm shift in the management of pregnant women with type 1 diabetes (T1D), with improved glycaemic control, less hypoglycaemia and fewer pregnancy complications. Data on CGM use in pregnant women with type 2 diabetes (T2D) are limited. A large randomized controlled trial (RCT) on CGM use in people with T2D in pregnancy is ongoing. Small studies on CGM use in women with gestational diabetes (GDM) have suggested improved glycaemic control and better qualification when insulin is needed. However, none of these studies was powered to evaluate pregnancy outcomes. Several large RCTs are ongoing in women with GDM. In addition to CGM, other technologies, such as advanced hybrid closed-loop (AHCL) systems have further improved glycaemic management in people with T1D. AHCL therapy adapts insulin delivery via a predictive algorithm integrated with CGM and an insulin pump. A large RCT with the AHCL CamAPS® FX demonstrated a 10% increase in time in range compared to standard insulin therapy in a pregnant population with T1D. Recently, an RCT of an AHCL system not approved for use in pregnancy (780G MiniMed) has also demonstrated additional benefits of AHCL therapy compared to standard insulin therapy, with improved time in range overnight, less hypoglycaemia and improved treatment satisfaction. More evidence is needed on the impact of AHCL therapy on maternal and neonatal outcomes and on which glycaemic targets with CGM should be used in pregnant women with T2D and GDM. We review the current evidence on the use of CGM and AHCL therapy in pregnancy.

Current Status of Cooperation Between Obstetric Care Institutes and Psychiatrists in Japan.

In May 2024, we requested all obstetric institutes (n = 1970) that are members of the Japan Association of Obstetricians and Gynecologists (JAOG) to provide information concerning the collaboration between obstetric institutes and psychiatrists in Japan, such as (1) pregnancy and delivery management of all pregnant women with psychiatric complications, and (2) availability of smooth collaboration with associated psychiatry (or psychiatrists) regarding pregnant women with psychiatric complications. Of the 1970 obstetric institutes, 1483 (75.2%) responded with valid information (completion of data submitted). In Japan, only 21% (308/1483) of all obstetric institutes are able to see all pregnant women with psychiatric complications who attend their hospital, and 32% (480/1483) of the institutes responded that they have smooth cooperation with associated psychiatrists. The response to pregnant women with mental health problems in Japanese obstetric institutes is not adequately equipped yet.