Search

Objective: This study aimed to evaluate the maternal and umbilical cord blood antibody levels, after COVID vaccination during pregnancy. Method: The women who received the COVID‐19 vaccine (Sinopharm) during pregnancy were included. Maternal and cord blood samples were tested to detect the severe acute respiratory syndrome coronavirus 2 receptor binding domain (RBD) specific antibodies. In addition, obstetric information and side effects after vaccination were gathered. Result: A total of 23 women were included. Eleven pregnant women took two doses and 12 cases received a single dose of the vaccine. No IgM antibody was detected in any maternal blood or cord blood samples. The RBD‐specific Immunoglobulin G (IgG) antibody was positive in mothers receiving 2 doses of the vaccine and their infants. But the antibody titers were under the positive cut‐off threshold for the other 12 women who were vaccinated with a single dose. Women who received both doses of vaccine had significantly higher IgG levels than a single dose of Sinopharm (p =.025). The same result was demonstrated in infants born to these mothers (p =.019). Conclusion: There was a significant correlation between maternal and neonatal IgG concentrations. Although, receiving both doses of the BBIBP‐CorV vaccine (not 1 dose) during pregnancy is highly beneficial for increasing humoral immunity for the mother and fetus. [ABSTRACT FROM AUTHOR]

Introduction Labor induction is an important issue in modern obstetrics. One of the important factors for the success of induction of labor is the Bishop score of cervix. Objective The purpose of the present study was to evaluate and compare the efficacy of dilapan with extra-amniotic saline infusion and oral misoprostol for cervical ripening in term pregnancies. Methods This clinical trial study was performed on 120 nulliparous pregnant women with the Bishop score of less than 5. Group one, group two and group three received dilapan, extra amniotic saline infusion (EASI) and misoprostol respectively. All three groups were compared for duration from beginning of the intervention up to cervical ripening and Bishop Score of ≥7, duration of active phase and the second stage of labor, number of deliveries in the first 24 h, duration from beginning of the intervention up to delivery, rout of delivery as well as neonatal weight, neonatal Apgar score; hyper- stimulation, and need for oxytocin and oxytocin doses administered after 12 h of intervention. Results The number of deliveries in the first 24 h after intervention were not significantly different between the three groups. There was no significant difference between the three groups according to duration from beginning of the intervention up to cervical ripening and Bishop Score of ≥7, duration of active phase and the second stage of labor, duration from beginning of the intervention up to delivery, rout of delivery as well as neonatal weight, neonatal Apgar score; and hyperstimulation. The Bishop Score was higher in the misoprostol group 6 h after intervention [dilapan: 4.32 ± 1.38, EASI: 5.47 ± 1.28, and misoprostol: 6.72 ± 1.61 (p = .000)], Oxytocin requirement [dilapan: 38 (95%) women, EASI: 37 (92.50%) and misoprostol: 30 (75%) women, p = .013], and required dose [dilapan: 7543 ± 2465 miu/ml, EASI: 5758 ± 1615miu/ml and misoprostol: 4930 ± 2589miu/ml, p = .000] were lower in misoprostol group. Conclusion Dilapan is an effective and safe method for cervical ripening in full term gestations. In cases where misoprostol and EASI cannot be used or are not desirable, dilapan can be used as an alternative. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the role of cerebroplacental ratio (CPR) in term pregnancies with reduced fetal movements (RFM) and appropriate for gestational age (AGA)fetuses to predict poor neonatal outcomes. A prospective cohort study was performed on 150 singleton pregnancies with gestational age of 37–41 weeks and multiple episodes of RFM (case group) and 150 pregnancies within the same criteria only without RFM (control group). Both groups had appropriate for gestational age (AGA)fetuses. Umbilical artery (UA) and middle cerebral artery (MCA) pulsatility indices (PI) were measured, and MCA to UA ratio (CPR) was calculated. Doppler indices and neonatal outcomes were compared between the two groups. Independent prediction role of CPR MoM was evaluated through a binary logistic regression method. The RFM group had significantly higher UA- PI MoM (1.01 ± 0.19 versus 0.86 ± 0.05, p <.001), lower MCA MoM (1.28 ± 0.20 versus 1.40 ± 0.13, (p <.001)) and lower CPR MoM (0.98 ± 0.24 versus 1.23 ± 0.12, (p <.001)) compared to the control group. Mean umbilical artery pH was lower in the RFM group and the frequency of neonatal UA cord pH <7.2 was higher in the RFM group. In RFM group, CPR MoM showed a significant linear correlation with birth weight centiles (r = 0.244, p =.003), umbilical artery pH (r = 0.319, p <.001) and Apgar score at minute 1 (r = 0.332, p <.001). CPR MoM exhibited negative correlation with duration of NICU stay (r= −0.187, p =.022). No similar correlation was observed in the control group. In binary logistic regression analysis, CPR MoM was adjusted for the results of NST; and it was concluded that CPR MoM was the only significant predictor of Apgar score minute 1 = <7 (OR: 0.004; 95% CI: 0.0002–0.0673, p <.001), umbilical artery ph <7.2 (OR: 0.019; 95% CI: 0.00005–0.0423, p <.001) and NICU admission (OR: 0.116; 95% CI: 0.018–0.744, p =.023). In multivariate binary logistic regression analysis included parity, history of abortion and ART, AFI, BPP and CPR MoM; the AFI (OR: 0.976; 95% CI: 0.957–0.995, p =.014), BPP (OR: 0.306; 95% CI: 0.172–0.545, p <.001) and CPR MoM (OR: 0.00005 95% CI: 0.000003–0.00061, p <.001) were the significant predictor of RFM. Area under the curve in receiver operating characteristics (ROC) curve was calculated as 0.828 for CPR MoM as a predictor of RFM (SE: 0.024, p <.001), yielding sensitivity and specificity estimates of 80.0% and 65.0%, respectively, using an optimal cutoff level of = < 1.19. This study concluded that reduced fetal movement was significantly related to low CPR MOM. Also, it showed the independent role of CPR MoM for prediction of lower neonatal umbilical artery pH, lower Apgar score minute 1 and higher rate of NICU admission in AGA term fetuses without considering NST results. Also, AFI, BPP and CPR MoM are significant predictors of RFM. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the relationship between fetal liver length (FLL) and maternal glycemic status in pregnant women with gestational diabetes mellitus (GDM), as well as to determine whether FLL measurement in the third trimester is associated with neonatal outcomes. A total of 51 singleton GDM pregnancies were included in this pilot study, and transabdominal ultrasound biometry and FLL measurements were performed between 34 and 36 weeks of gestation. Maternal indicators of glycemic control, including hemoglobin A1C (HbA1C), fasting blood sugar (FBS), and 2-h postprandial blood sugar were also evaluated during this period. The cases were followed up until delivery and maternal and neonatal outcomes were assessed to determine any correlation with FLL. The results showed a significant positive correlation between FLL and HbA1C (r = 0.464, P = 0.001), FBS (r = 0.574, P < 0.001), 2-h postprandial blood sugar (r = 0.405, P = 0.002), and AC (r = 0.515, P < 0.001). Additionally, FLL was significantly associated with fetal birth weight (r = 0.408, P = 0.003) and birth weight (r = 0.460, P = 0.001). The FLL≥95th percentile group demonstrated a higher number of polyhydramnios (p = 0.007), macrosomia (p < 0.001), and maternal intensive care unit (ICU) admissions (p = 0.006). In conclusion, FLL measurement during third trimester of pregnancy is an indicator of maternal glycemic regulation and can be used as a predictor of macrosomia and neonatal birth weight in GDM pregnancies. • Uncontrolled GDM is significantly associated with several pregnancy complications. • Estimated fetal weight may not be an accurate predictor of macrosomia and prenatal complications. • Fetal liver length measurement may be an accurate marker for monitoring maternal glycemic control. • It also could be used to predict maternal and neonatal complications in GDM pregnancies. [ABSTRACT FROM AUTHOR]