Pregnancy

OBJECTIVES: To examine the potential value of maternal ophthalmic artery Doppler at 35-37 weeks' gestation in combination with the established biomarkers of preeclampsia (PE), including mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI), serum placental growth factor (PlGF) and serum soluble fms-like tyrosine kinase-1 (sFLT), in the prediction of subsequent development of PE. METHODS: This was a prospective observational study in women attending for a routine hospital visit at 35+0 - 36+6 weeks' gestation...

BACKGROUND: The value of using customized birthweight centiles to improve the diagnostic accuracy for fetal growth restriction (FGR), in comparison with using population-based charts, remains a matter of debate. One potential explanation for the conflicting data is that most studies used measures of perinatal mortality and morbidity as proxies for placenta-mediated FGR. However, many of these outcomes are not specific to placenta-mediated FGR, and may be confounded by other factors such as prematurity...

OBJECTIVE: Selective fetal growth restriction (sFGR) complicating twin to twin transfusion syndrome (TTTS) is associated with 3 to 6 fold increased risk of fetal demise after fetoscopic laser surgery (FLS). Identifying these patients is challenging due to varying definitions used in the literature. Our objective was to determine the association of three currently used definitions for sFGR with demise of the smaller twin, typically the donor, following FLS METHODS: Retrospective cohort of monochorionic diamniotic pregnancies undergoing FLS for TTTS between January 2015 to December 2018...

OBJECTIVE: Type III selective intrauterine growth restriction (sIUGR) is associated with a high and unpredictable risk of fetal death and fetal brain injury. Our objective was to describe the prospective risk of fetal death and the risk of adverse neonatal outcomes in a contemporary cohort. METHODS: We retrospectively reviewed all monochorionic diamniotic twin pregnancies complicated by type III sIUGR managed at nine fetal centers over a 12-year time period. Higher order multiples, major fetal anomalies or other monochorionicity related complications at initial presentation were excluded...

We investigated the applicability of ssGBLUP methodology under the autoregressive model (H-AR) for genomic evaluation of longitudinal reproductive traits in Portuguese Holstein cattle. The genotype data of 1,230 bulls and 1,645 cows were considered in our study. The reproductive traits evaluated were interval from calving to first service (ICF), calving interval (CI) and daughter pregnancy rate (DPR) measured during the first four parities. Reliability and rank correlation were used to compare the H-AR with the traditional pedigree-based autoregressive models (A-AR)...

OBJECTIVES: To observe the microvascular architecture in the placental bed and explore the feasibility and clinical utility of MV-Flow imaging (Samsung Medison Co, Ltd, Seoul, Korea) during normal pregnancy and fetal growth restriction (FGR). METHODS: Placental microvascular structure ultrasound imaging by MV-Flow was performed on 227 unaffected and 17 FGR fetuses between 11 and 41 weeks' gestation. A placental vascular index (VIMV ) was acquired by application of various MV-Flow regions of interest (ellipse, rectangle, and manual trace)...

This study provides insight into the extent to which public commitment to reduce teenage pregnancy made by the President of Sierra Leone made the issue a political priority and the factors that facilitated and hindered this. Using historical observations from government and civil society actors who were involved in the formulation and implementation of the country's National Strategy for the Reduction of Teenage Pregnancy (NSRTP), the study presents lessons learnt, with a particular focus on advocacy. It does not examine the extent to which the NSRTP was operationalised and its objectives fulfilled...

The aim of this study was to evaluate clinicians' views of managing women with first-trimester Recurrent Miscarriage within the UK compared with RCOG guidance. An online survey of 150 Association of Early Pregnancy Units members was conducted using SurveyMonkey™. Analysis was limited to UK-based respondents (102). Of the three key investigations, 98% performed antiphospholipid antibodies (APA) screening, 93.1% performed karyotyping for subsequent miscarriages and 86.3% performed a pelvic ultrasound routinely...

Preeclampsia (PE) remains a leading cause of maternal morbidity and mortality all over the world. However, its aetiology and pathophysiology remain elusive. Platelet activating factor (PAF) is produced in response to oxidative stress and is a potent hypotensive agent. PAF acetylhydrolase (PAF-AH) inactivates PAF and is seen to decrease in normotensive women. The role of PAF-AH in preeclampsia has been in investigational literature, so far. The few studies done have shown a positive association of elevated levels of PAF-AH with preeclampsia...

In this study, the level of serum anti-angiotensin II type 1 receptor autoantibodies (AT1-AA) was determined. It was found that the positive rate of AT1-AA in serum of infertile women is higher than that of healthy non-pregnant women. Spearman correlation analysis showed that AT1-AA was negatively correlated with oocyte maturation rate (r = -0.29, P < 0.01) and AT1-AA was positively correlated with IL-6 (r = 0.68, P < 0.01). Logistic regression analysis showed that age, BMI, type of infertility, years of infertility, history of poor pregnancy outcome, condition of fallopian tube, and polycystic ovary syndrome were not factors influencing the level of AT1-AA in the serum of infertile patients...

The global burden of rheumatic heart disease continues to be significant although it is largely limited to poor and marginalized populations. In most endemic regions, affected patients present with heart failure. This statement will seek to examine the current state-of-the-art recommendations and to identify gaps in diagnosis and treatment globally that can inform strategies for reducing disease burden. Echocardiography screening based on World Heart Federation echocardiographic criteria holds promise to identify patients earlier, when prophylaxis is more likely to be effective; however, several important questions need to be answered before this can translate into public policy...

Preeclampsia is a pregnancy disorder, whereas the underlying mechanisms and etiological factors of this complication remain elusive. Studies have reported that decreased invasiveness of trophoblast cells, immunity disorder in the maternal-fetal interface, and oxidative stress may contribute to the development of preeclampsia. In the present study, we firstly co-cultured the smooth muscle cells (SMCs) and endothelial cells (ECs) to mimic the decidua and myometrium interface and examined the effects of osteopontin (OPN) on the invasive potential of trophoblasts in the SMC-EC co-culturing system...

BACKGROUND: Pre-eclampsia (PE) is dangerous complication, which leads to adverse pregnancy outcomes. AIMS: The study was to explore the correlation between serum level of fibroblast growth factor (FGF) 21 and PE. METHODS: A total of 80 cases were involved in this study containing PE group (49 cases) and control group (31 cases, normal pregnancy). PE group was divided into early-onset PE (EOPE) and late-onset PE (LOPE). Serum level of FGF21 and biochemical parameters were measured before delivery...

The emergence of continuous glucose monitoring has driven improvements in glycaemic control and quality of life for people with diabetes. Recent changes in access to continuous glucose monitoring systems within UK health services have increased the number of people able to benefit from these technologies. The COVID-19 pandemic has created an opportunity for diabetes healthcare professionals to use continuous glucose monitoring technology to remotely deliver diabetes services to support people with diabetes...

PURPOSE: We performed a systematic review and meta-analysis of available literature to investigate the efficacy of the intracytoplasmic sperm injection (ICSI) in couples with non-male factor with respect to the clinical outcomes. METHODS: The literature search was based on EMBASE, PubMed, and the Cochrane Library. All studies published after 1992 until February 2020 and written in English addressing patients in the presence of normal semen parameters subjected to ICSI and in vitro fertilization (IVF) were eligible...

BACKGROUND: Impact of heart disease (HD) on pregnancy is significant. OBJECTIVE: We aimed to evaluate the feasibility of integrating screening echocardiography (echo) into the Brazilian prenatal primary care to assess HD prevalence. METHODS: Over 13 months, 20 healthcare workers acquired simplified echo protocols, utilizing hand-held machines (GE-VSCAN), in 22 primary care centres. Consecutive pregnant women unaware of HD underwent focused echo, remotely interpreted in USA and Brazil...

Background: Prenatal Alcohol Exposure (PAE) impacts 2% to 5% of infants born in the United States yearly. Women who consume alcohol during pregnancy have a five-fold increased rate of Chorioamnionitis (CHORIO). Both PAE and CHORIO cause microstructural injury to multiple brain regions including major white matter tracts. Objective: Utilizing two previously established animal models, we hypothesized that the combination of PAE+CHORIO would result in greater deficits in myelination and structural integrity than PAE alone...

Overweight and obesity during pregnancy are risk factors for a large number of perinatal complications, both for the mother and the infant. Risk stratification and early interventions are therefore highly clinically important to minimize future complications. Currently, body mass index (BMI) in early pregnancy is used for risk stratification of pregnant women, but a disadvantage of BMI is that it does not distinguish muscle from fat tissue and central from peripheral adiposity. Maternal fat distribution is suggested to be a better predictor than BMI of obesity-related adverse pregnancy outcomes, with central adiposity posing a greater risk than peripheral subcutaneous fat...

The recent development of modulators of cystic fibrosis transmembrane conductance regulator (CFTR) has allowed the life expectancy of cystic fibrosis patients to increase substantially resulting in more women with cystic fibrosis reaching child-bearing age. This however raises the issue of whether long-term use of CFTR modulators during pregnancy and breastfeeding is safe for the fetus and newborn, especially for their developing brain. A very limited number of case reports available so far has shown that the fetus or breastfed newborn is likely to be exposed to maternally administered CFTR modulators...

Background: Advances in metabolomics are anticipated to decipher associations between dietary exposures and health. Replication biomarker studies in different populations are critical to demonstrate generalizability. Objectives: To identify and validate robust serum metabolites associated with diet quality and specific foods in a multiethnic cohort of pregnant women. Design: In this cross-sectional analysis of 3 multiethnic Canadian birth cohorts, we collected semiquantitative FFQ and serum data from 900 women at the second trimester of pregnancy...